Organization
CCN AMERICA LP
Active
Other names
Coordinated Care Network Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS POLLACK (PRESIDENT AND CFO)
(412) 349-6300
Entity
Organization
Contact information
Practice address
249 S 13TH ST, PHILADELPHIA, PA 19107-5640
(844) 657-6786
(267) 324-3594
Mailing address
300 PENN CENTER BLVD, SUITE 505, PITTSBURGH, PA 15235-5511
(412) 349-6300
(412) 349-6724
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482532
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018103020002
—
PA
01
—
2149363
PK
—
Enumeration date
12/22/2014
Last updated
02/24/2022
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