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NPI Code Detail

MEDICARE: MRS. MICHELLE MARIE SULLIVAN RPH

MEDICARE: MRS. MICHELLE MARIE SULLIVAN RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRP041067LPA

General Provider Information

NPI Number : 1033265350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE MARIE SULLIVAN RPH
Provider Business Mailing Address
First Line : 4949 OAKHURST AVE
Second Line :
City : GIBSONIA
State : PA
Zip : 15044-8393
Country : US
Telephone Number : 724-443-6902
Fax Number :
Provider Business Practice Location Address
First Line : 915 MOUNT ROYAL BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15223-1046
Country : US
Telephone Number : 412-486-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MICHELLE MARIE SULLIVAN RPH” Practice Location

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