Provider Demographics
NPI:1598873168
Name:HCBR LLC TENTH STREET PHARMACY
Entity Type:Organization
Organization Name:HCBR LLC TENTH STREET PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/R.PH
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-559-6598
Mailing Address - Street 1:938 FALLOWFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2104
Mailing Address - Country:US
Mailing Address - Phone:724-483-5302
Mailing Address - Fax:724-483-2210
Practice Address - Street 1:938 FALLOWFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2104
Practice Address - Country:US
Practice Address - Phone:724-483-5302
Practice Address - Fax:724-483-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP412999L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3916004OtherNCPDP NUMBER
PAPP412999LOtherSTATE PERMIT
PAPP412999LOtherSTATE PERMIT
3916004OtherNCPDP NUMBER