1467652396 NPI number — DR. RENEE MARIE RICHARDSON PHARMD

Table of content: WARNER PENG MD (NPI 1154584704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467652396 NPI number — DR. RENEE MARIE RICHARDSON PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDSON
Provider First Name:
RENEE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALSBERRY
Provider Other First Name:
RENEE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467652396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 KAPPA DRIVE
Provider Second Line Business Mailing Address:
PHARMACY DEPARTMENT
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15238-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-980-9101
Provider Business Mailing Address Fax Number:
412-968-1561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 KAPPA DR
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15238-2809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-963-2383
Provider Business Practice Location Address Fax Number:
412-968-1561
Provider Enumeration Date:
07/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PI108050 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: RP443842 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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