Healthcare Provider Details

I. General information

NPI: 1699164863
Provider Name (Legal Business Name): MEMAW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 VIRGINIA AVE FL 3
ROCHESTER PA
15074-1723
US

IV. Provider business mailing address

1314 7TH AVE
BEAVER FALLS PA
15010-4217
US

V. Phone/Fax

Practice location:
  • Phone: 724-987-6085
  • Fax: 724-987-6084
Mailing address:
  • Phone: 724-987-6085
  • Fax: 724-987-6084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482536
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC DAVIS
Title or Position: OWNER
Credential:
Phone: 412-298-3360