Healthcare Provider Details

I. General information

NPI: 1558080184
Provider Name (Legal Business Name): EVAN MICHAEL DRNEVICH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 PENNSYLVANIA AVE
PITTSBURGH PA
15233-1407
US

IV. Provider business mailing address

9067 MEADOW OAKS DR
ALLISON PARK PA
15101-2830
US

V. Phone/Fax

Practice location:
  • Phone: 412-231-0868
  • Fax:
Mailing address:
  • Phone: 412-760-3817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457054
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: