Provider Demographics
NPI:1477947323
Name:HARCUM PHARMACY INC
Entity Type:Organization
Organization Name:HARCUM PHARMACY INC
Other - Org Name:THE MEDICINE SHOPPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMERTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-561-3180
Mailing Address - Street 1:524 BROOKLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2002
Mailing Address - Country:US
Mailing Address - Phone:412-561-3180
Mailing Address - Fax:412-561-3188
Practice Address - Street 1:524 BROOKLINE BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-2002
Practice Address - Country:US
Practice Address - Phone:412-561-3180
Practice Address - Fax:412-561-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
PAPP415169L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2151345OtherPK
PA1030009100001Medicaid