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General NPI Number Information
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NPI Number | 1427451764
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Entity Type | Organization
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Legal Business Name | ALLEGHENY CLINIC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 12311 PERRY HWY STE F
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City | WEXFORD
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State | PA
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Zip | 15090-8344
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Country | US
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Telephone | 878-332-4118
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Fax | 878-332-4472
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Provider Business Mailing Address
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Address Line | 12311 PERRY HIGHWAY SUITE F
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City | WEXFORD
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State | PA
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Zip | 15090
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Country | US
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Telephone | 878-332-4118
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Fax | 878-332-4472
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Authorized Official
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Title or Position | DIRECTOR REIMBURSEMENT
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Name | ANDREW TISCH
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Credential |
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Telephone | 412-330-6062
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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 | PP482517
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License Number State | PA
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