Organization
ALLEGHENY COUNTY
Active
Other names
kane regional ctr Glen hazel Pharmacy, Kane Regional Center Glen Hazel Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BABU SRINIVAS (CFO)
(412) 422-6904
Entity
Organization
Contact information
Practice address
955 RIVERMONT DR, PITTSBURGH, PA 15207-1347
(412) 422-6050
(412) 422-6966
Mailing address
955 RIVERMONT DR, PITTSBURGH, PA 15207-1347
(412) 422-6050
(412) 422-6966
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009363430005
—
PA
01
—
3946716
NABP
—
01
—
HP-418354L
PHARMACY LICENSE
PA
Enumeration date
11/30/2006
Last updated
03/07/2023
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