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General NPI Number Information
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NPI Number | 1215088208
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PHARMACY SERVICES INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 2550 MOSSIDE BLVD STE 210
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City | MONROEVILLE
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State | PA
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Zip | 15146-3540
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Country | US
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Telephone | 412-380-5230
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Fax | 412-380-5233
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Provider Business Mailing Address
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Address Line | 2550 MOSSIDE BLVD STE 210
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City | MONROEVILLE
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State | PA
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Zip | 15146-3540
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Country | US
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Telephone | 412-380-5230
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Fax | 412-380-5233
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Authorized Official
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Title or Position | OWNER PHCST
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Name | ANTHONY BERTOLA
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Credential | RPH
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Telephone | 412-583-6332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP481636
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License Number State | PA
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