Healthcare Provider Details

I. General information

NPI: 1932873304
Provider Name (Legal Business Name): MICHELLE KOVERMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 CENTRE AVE
PITTSBURGH PA
15232-1303
US

IV. Provider business mailing address

3600 FORBES AVE STE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2287
  • Fax:
Mailing address:
  • Phone: 314-341-9104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP455913
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: