Provider Demographics
NPI:1144235078
Name:THE TAMARKIN COMPANY
Entity Type:Organization
Organization Name:THE TAMARKIN COMPANY
Other - Org Name:GIANT EAGLE PHARMACY #0095
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE CONTRACTING & CREDENTIALI
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-967-4775
Mailing Address - Street 1:101 KAPPA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18511 SMOCK HWY
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3672
Practice Address - Country:US
Practice Address - Phone:814-724-6292
Practice Address - Fax:330-829-3194
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIANT EAGLE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-29
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2595982Medicaid
PAP00419123OtherMEDICARE RAILRAOD FLU TAMARKIN PA
PA1007285680237Medicaid
3971226OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA1007285680237Medicaid
PA2595982Medicaid