Provider Demographics
NPI:1083625651
Name:JOHNSONS PHARMACUETICAL SERVICES INC
Entity Type:Organization
Organization Name:JOHNSONS PHARMACUETICAL SERVICES INC
Other - Org Name:JOHNSONS PHARMACUETICAL SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-655-2151
Mailing Address - Street 1:2000 CLAIRTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-3006
Mailing Address - Country:US
Mailing Address - Phone:412-655-2151
Mailing Address - Fax:412-655-3635
Practice Address - Street 1:2000 CLAIRTON RD
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-3006
Practice Address - Country:US
Practice Address - Phone:412-655-2151
Practice Address - Fax:412-655-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP415463L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017209000001Medicaid
2133446OtherPK
PA0017209000001Medicaid