Provider Demographics
NPI:1295755510
Name:UNIVERSITY OF PITTSBURGH
Entity type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGLIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:141-238-3185
Mailing Address - Street 1:103 UNIVERSITY PLACE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15260
Mailing Address - Country:US
Mailing Address - Phone:412-383-1850
Mailing Address - Fax:412-383-1855
Practice Address - Street 1:103 UNIVERSITY PLACE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15260
Practice Address - Country:US
Practice Address - Phone:412-383-1850
Practice Address - Fax:412-383-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAHP418333L3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082776OtherPK
PA1001381400034Medicaid