Healthcare Provider Details

I. General information

NPI: 1710890504
Provider Name (Legal Business Name): KRISTOFER POTTS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 FREEPORT ROAD
PITTSBURGH PA
15238-6178
US

IV. Provider business mailing address

601 DELAWARE AVE
OAKMONT PA
15139-1607
US

V. Phone/Fax

Practice location:
  • Phone: 412-781-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460422
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: