Provider Demographics
NPI:1508151226
Name:SPARTAN PHARMACY INC.
Entity Type:Organization
Organization Name:SPARTAN PHARMACY INC.
Other - Org Name:SPARTAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-884-5650
Mailing Address - Street 1:3526 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3116
Mailing Address - Country:US
Mailing Address - Phone:412-884-5650
Mailing Address - Fax:412-884-5651
Practice Address - Street 1:3520 CLAIRTON BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:PA
Practice Address - Zip Code:15227-2720
Practice Address - Country:US
Practice Address - Phone:412-440-5888
Practice Address - Fax:412-885-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4821273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy