MEDICARE: ALEXANDROS C PITSAKIS PHARMD

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	RP454779	PA

General Provider Information

NPI Number	:	1972109064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDROS C PITSAKIS PHARMD

Provider Business Mailing Address
First Line	:	970 RITTENHOUSE RD STE 200
Second Line	:
City	:	AUDUBON
State	:	PA
Zip	:	19403-2265
Country	:	US
Telephone Number	:	610-344-0450
Fax Number	:

Provider Business Practice Location Address
First Line	:	970 RITTENHOUSE RD
Second Line	:
City	:	AUDUBON
State	:	PA
Zip	:	19403-2265
Country	:	US
Telephone Number	:	610-344-0450
Fax Number	:

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

Provider Enumeration Date	:	12/05/2020
Last Update Date	:	07/01/2023

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