MEDICARE: MS. IRENE MARIE DAMRATOSKI 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
1	183500000X	Pharmacist	RP024952L	PA

General Provider Information

NPI Number	:	1417938424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRENE MARIE DAMRATOSKI RPH

Provider Business Mailing Address
First Line	:	229 ROYCROFT AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1244
Country	:	US
Telephone Number	:	412-343-5373
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:	ASTIS PHARMACY
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-561-2347
Fax Number	:	412-680-4842

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	07/08/2007

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