=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124521224
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE FREEDY RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2018
-----------------------------------------------------
Last Update Date | 03/14/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 250 MOUNT LEBANON BLVD
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15234-1252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-561-2347
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 253 PARK ENTRANCE DR
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15228-1824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-571-9199
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP041113L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------