Healthcare Provider Details

I. General information

NPI: 1114911302
Provider Name (Legal Business Name): T E P INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 5TH AVE
NEW BRIGHTON PA
15066-1737
US

IV. Provider business mailing address

525 5TH AVE
NEW BRIGHTON PA
15066-1737
US

V. Phone/Fax

Practice location:
  • Phone: 724-847-7979
  • Fax: 724-847-1774
Mailing address:
  • Phone: 724-847-7979
  • Fax: 724-847-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP414812L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPP414812L
License Number StatePA

VIII. Authorized Official

Name: MR. HARRY MURRAY DAVIS
Title or Position: OWNER/PHARMACIST
Credential: R.PH.
Phone: 724-847-7979