Healthcare Provider Details

I. General information

NPI: 1386703924
Provider Name (Legal Business Name): STANTON NEGLEY DRUG CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 N NEGLEY AVE
PITTSBURGH PA
15206-1504
US

IV. Provider business mailing address

804 N NEGLEY AVE
PITTSBURGH PA
15206-1504
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-3315
  • Fax: 412-661-1114
Mailing address:
  • Phone: 412-661-3315
  • Fax: 412-661-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP412379L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND VELLKY
Title or Position: PHARMACY MANAGER
Credential:
Phone: 412-661-3315