Healthcare Provider Details

I. General information

NPI: 1366963894
Provider Name (Legal Business Name): MAHALIA HARRELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UPMC MONTEFIORE 3459 5TH AVE
PITTSBURGH PA
15213-3236
US

IV. Provider business mailing address

3459 5TH AVE
PITTSBURGH PA
15213-3236
US

V. Phone/Fax

Practice location:
  • Phone: 412-234-5678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP451129
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: