MEDICARE: DAVID JAMES GREENLEE 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	RP030052L	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	:	1568885929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID JAMES GREENLEE RPH

Provider Business Mailing Address
First Line	:	114 GRANT AVE
Second Line	:	ROSS PHARMACY
City	:	VANDERGRIFT
State	:	PA
Zip	:	15690-1208
Country	:	US
Telephone Number	:	724-568-1221
Fax Number	:	724-567-7185

Provider Business Practice Location Address
First Line	:	114 GRANT AVE
Second Line	:
City	:	VANDERGRIFT
State	:	PA
Zip	:	15690-1208
Country	:	US
Telephone Number	:	724-568-1221
Fax Number	:	724-567-7185

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

Provider Enumeration Date	:	01/21/2014
Last Update Date	:	01/21/2014

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