MEDICARE: GAYLE A COTCHEN R.PH., MBA

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	183500000X	Pharmacist	RP028993L	PA

General Provider Information

NPI Number	:	1386642700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYLE A COTCHEN R.PH., MBA

Provider Business Mailing Address
First Line	:	1097 WOODHILL DR
Second Line	:
City	:	GIBSONIA
State	:	PA
Zip	:	15044-9271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HALKET ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3108
Country	:	US
Telephone Number	:	412-641-4356
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	07/08/2007

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