Healthcare Provider Details

I. General information

NPI: 1497456909
Provider Name (Legal Business Name): JOHN JOSEPH VATER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 03/13/2023
Certification Date: 03/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ERICSSON DR
WARRENDALE PA
15086-6501
US

IV. Provider business mailing address

3934 FOSTER ST # B532
PITTSBURGH PA
15201-3271
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPI013408
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: