Healthcare Provider Details

I. General information

NPI: 1043959539
Provider Name (Legal Business Name): CPRX MSO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/02/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 OAKDALE RD STE 2
OAKDALE PA
15071-1502
US

IV. Provider business mailing address

1001 OAKDALE RD STE 2
OAKDALE PA
15071-1502
US

V. Phone/Fax

Practice location:
  • Phone: 800-755-4704
  • Fax: 412-920-2883
Mailing address:
  • Phone: 800-755-4704
  • Fax: 412-920-2883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN PATRICK
Title or Position: PRESIDENT
Credential:
Phone: 412-733-1910