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General NPI Number Information
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NPI Number | 1346352580
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Entity Type | Organization
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Legal Business Name | WALTMIRE PHARMACY LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1435 SPRING GARDEN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-3711
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Country | US
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Telephone | 412-323-1801
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Fax | 412-323-1687
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Provider Business Mailing Address
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Address Line | 1435 SPRING GARDEN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-3711
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Country | US
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Telephone | 412-323-1801
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Fax | 412-323-1687
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Authorized Official
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Title or Position | OWNER
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Name | MR. DONALD WARREN WALTMIRE
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Credential | RPH
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Telephone | 412-323-1801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP027644L
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License Number State | PA
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