Provider Demographics
NPI:1184775306
Name:PRECISION CARE PHARMACY
Entity type:Organization
Organization Name:PRECISION CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-532-2120
Mailing Address - Street 1:1906 DAILEY AVE.
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3030
Mailing Address - Country:US
Mailing Address - Phone:724-532-2120
Mailing Address - Fax:724-532-5808
Practice Address - Street 1:1906 DAILEY AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-3030
Practice Address - Country:US
Practice Address - Phone:724-532-2120
Practice Address - Fax:724-532-5808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481107333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018911480003Medicaid
PA3980314OtherNABP-NCPDP
PA5570270001Medicare NSC