MEDICARE: CALLIGAN PHARMACY LLC

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
1	333600000X	Pharmacy	PP410334L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083609721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALLIGAN PHARMACY LLC

Provider Business Mailing Address
First Line	:	412 E 4TH AVE
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-1810
Country	:	US
Telephone Number	:	724-224-3334
Fax Number	:	724-224-4413

Provider Business Practice Location Address
First Line	:	412 E 4TH AVE
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-1810
Country	:	US
Telephone Number	:	724-224-3334
Fax Number	:	724-224-4413

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. AMY M. CAMP
Credential	:	RPH
Telephone Number	:	724-224-3334

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	08/22/2020

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