Healthcare Provider Details

I. General information

NPI: 1417938424
Provider Name (Legal Business Name): IRENE MARIE DAMRATOSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MOUNT LEBANON BLVD ASTIS PHARMACY
PITTSBURGH PA
15234-1252
US

IV. Provider business mailing address

229 ROYCROFT AVE
PITTSBURGH PA
15234-1244
US

V. Phone/Fax

Practice location:
  • Phone: 412-561-2347
  • Fax: 412-680-4842
Mailing address:
  • Phone: 412-343-5373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP024952L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: