Healthcare Provider Details

I. General information

NPI: 1285717637
Provider Name (Legal Business Name): HEIGHTS PRESCRIPTION PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 LONGFELLOW ST STE 100
VANDERGRIFT PA
15690-1476
US

IV. Provider business mailing address

224 LONGFELLOW ST STE 100
VANDERGRIFT PA
15690-1476
US

V. Phone/Fax

Practice location:
  • Phone: 724-567-6615
  • Fax: 724-568-1608
Mailing address:
  • Phone: 724-567-6615
  • Fax: 724-568-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPP411945L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP411945L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1007627200001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier3942100
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerNCPDP

VIII. Authorized Official

Name: ALEXANDER J MICKLOW
Title or Position: SECRETARY
Credential: R.PH.
Phone: 724-567-6615