Provider Demographics
NPI:1467503292
Name:UNION PRESCRIPTION CENTER
Entity Type:Organization
Organization Name:UNION PRESCRIPTION CENTER
Other - Org Name:UNION PRESCRIPTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:BORRELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-684-8350
Mailing Address - Street 1:401 DONNER AVE
Mailing Address - Street 2:
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-1152
Mailing Address - Country:US
Mailing Address - Phone:724-684-8350
Mailing Address - Fax:724-684-8357
Practice Address - Street 1:401 DONNER AVE
Practice Address - Street 2:
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062-1152
Practice Address - Country:US
Practice Address - Phone:724-684-8350
Practice Address - Fax:724-684-8357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336L0003X
PAPP412651L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00101061000Medicaid
PA0010106100001Medicaid