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General NPI Number Information
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NPI Number | 1316150741
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Entity Type | Organization
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Legal Business Name | GREEN PARK HEALTH LLC DBA TROY PHARMACY
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1612 LOWRIE STREET TROY PHARMACY
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City | PITTSBURGH
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State | PA
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Zip | 15212
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Country | US
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Telephone | 412-904-2231
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Fax | 412-904-2605
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Provider Business Mailing Address
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Address Line | 1612 LOWRIE STREET
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City | PITTSBURGH
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State | PA
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Zip | 15212
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Country | US
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Telephone | 412-732-0292
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Fax | 412-904-2605
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. JAMES CONRAD BURKE
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Credential | RPH RP032893L
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Telephone | 412-915-3510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482013
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License Number State | PA
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Taxonomy #2
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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 #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP482013
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PP482013
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License Number State | PA
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