Healthcare Provider Details

I. General information

NPI: 1972231371
Provider Name (Legal Business Name): RYAN TOBER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST STE 5150
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

83 N JACKSON AVE
PITTSBURGH PA
15202-3008
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-6451
  • Fax:
Mailing address:
  • Phone: 518-317-8042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRP457018
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457018
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: