Individual
BLAKE THOMAS MCGOURTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
250 SUMMIT PARK DR, PITTSBURGH, PA 15275-1202
(412) 788-9110
Mailing address
250 SUMMIT PARK DR, PITTSBURGH, PA 15275-1202
(412) 788-9110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP0011481
WV
183500000X
Pharmacist
Primary
RP448213
PA
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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