MEDICARE: MS. AMY J BALOH 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	RP039993L	PA

General Provider Information

NPI Number	:	1639177231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY J BALOH RPH

Provider Business Mailing Address
First Line	:	4510 NORWIN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-1845
Country	:	US
Telephone Number	:	412-207-9111
Fax Number	:	412-207-9112

Provider Business Practice Location Address
First Line	:	600 WILLOWBROOK PLZ
Second Line	:	ROUTE 51N
City	:	BELLE VERNON
State	:	PA
Zip	:	15012-4010
Country	:	US
Telephone Number	:	724-379-6000
Fax Number	:	724-379-8548

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

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

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