MEDICARE: MURRAY AVENUE APOTHECARY, 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	183500000X	Pharmacist	RP039741L	PA

General Provider Information

NPI Number	:	1922127273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURRAY AVENUE APOTHECARY, INC.

Provider Business Mailing Address
First Line	:	4227 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2903
Country	:	US
Telephone Number	:	412-421-4996
Fax Number	:	412-421-6500

Provider Business Practice Location Address
First Line	:	4227 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2903
Country	:	US
Telephone Number	:	412-421-4996
Fax Number	:	412-421-6500

Authorized Official
Title or Position	:	PHARMACIST
Name	:	SUSAN MERENSTEIN
Credential	:
Telephone Number	:	412-421-4996

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/22/2020

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