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General NPI Number Information
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NPI Number | 1609401926
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Entity Type | Organization
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Legal Business Name | BLUEBERRY PHARMACY
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Dates
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Enumeration Date | 03/06/2020
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1018 W VIEW PARK DR
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City | PITTSBURGH
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State | PA
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Zip | 15229-1771
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Country | US
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Telephone | 412-612-2279
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Fax | 888-852-4489
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Provider Business Mailing Address
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Address Line | 1018 W VIEW PARK DR
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City | PITTSBURGH
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State | PA
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Zip | 15229-1771
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Country | US
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Telephone | 412-612-2279
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Fax | 888-852-4489
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KYLE RICHARD MCCORMICK
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Credential | PHARMD
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Telephone | 412-612-2279
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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 |
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License Number State |
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