Healthcare Provider Details

I. General information

NPI: 1730539891
Provider Name (Legal Business Name): THE RX SHOPPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 56TH ST
PITTSBURGH PA
15201-2322
US

IV. Provider business mailing address

450 56TH ST
PITTSBURGH PA
15201-2322
US

V. Phone/Fax

Practice location:
  • Phone: 724-816-2512
  • Fax: 724-857-5111
Mailing address:
  • Phone: 724-816-2512
  • Fax: 724-857-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StatePA

VIII. Authorized Official

Name: MS. LISA ANN BROSKY
Title or Position: THIRD PARTY MANAGER
Credential:
Phone: 724-378-5325