Healthcare Provider Details

I. General information

NPI: 1790456697
Provider Name (Legal Business Name): BRITTANY BLAHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 LONG RUN RD
WHITE OAK PA
15131-2035
US

IV. Provider business mailing address

2612 BICKERSTAFF RD
IRWIN PA
15642-9735
US

V. Phone/Fax

Practice location:
  • Phone: 412-678-2755
  • Fax:
Mailing address:
  • Phone: 412-529-1399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP456202
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: