MEDICARE: FAMCARE PRESCRIPTION AND HEALTH CENTER OF BURGETTSTOWN, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	PP413903L	PA

General Provider Information

NPI Number	:	1639175656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMCARE PRESCRIPTION AND HEALTH CENTER OF BURGETTSTOWN, INC.

Provider Business Mailing Address
First Line	:	1429 BURGETTSTOWN PLAZA
Second Line	:
City	:	BURGETTSTOWN
State	:	PA
Zip	:	15021
Country	:	US
Telephone Number	:	724-947-7000
Fax Number	:	724-947-5699

Provider Business Practice Location Address
First Line	:	1429 BURGETTSTOWN PLAZA
Second Line	:
City	:	BURGETTSTOWN
State	:	PA
Zip	:	15021
Country	:	US
Telephone Number	:	724-947-7000
Fax Number	:	724-947-5699

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RITA B. CASKEY
Credential	:	R. PH.
Telephone Number	:	724-947-7000

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/10/2008

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