=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093021735
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRISHA MCINTYRE PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2010
-----------------------------------------------------
Last Update Date | 08/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 E HIGH ST
-----------------------------------------------------
City | UNION CITY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16438-1055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-438-3112
-----------------------------------------------------
Fax | 814-438-8023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 E HIGH ST
-----------------------------------------------------
City | UNION CITY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16438-1055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-438-3112
-----------------------------------------------------
Fax | 814-438-8023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP438157
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------