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General NPI Number Information
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NPI Number | 1831132174
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 4501 ADMIRAL PEARY HWY
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City | EBENSBURG
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State | PA
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Zip | 15931-4332
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Country | US
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Telephone | 814-472-0495
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Fax | 814-472-0572
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Provider Business Mailing Address
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Address Line | 4501 ADMIRAL PEARY HWY
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City | EBENSBURG
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State | PA
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Zip | 15931-4332
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF PHARMACIST
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Name | CHRISTINE GRIFFITH
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Credential |
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Telephone | 814-472-0498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 3336I0012X
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Taxonomy Name | Institutional 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 | PP417043L
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License Number State | PA
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