1063427995 NPI number — THE TAMARKIN COMPANY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063427995 NPI number — THE TAMARKIN COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE TAMARKIN COMPANY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GIANT EAGLE PHARMACY 4050
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063427995
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 KAPPA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15238-2809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9125 RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GIRARD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16417-9645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-774-2467
Provider Business Practice Location Address Fax Number:
814-774-7216
Provider Enumeration Date:
07/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ELMS
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
INSURANCE CONTRACTING & CREDENTIALI
Authorized Official Telephone Number:
412-967-4775

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  020379550 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1007764670027 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3965007 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00419123 . This is a "MEDICARE RAILROAD FLU (TAMARKIN PA)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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