Provider Demographics
NPI:1609311299
Name:TWINSRX LLC
Entity Type:Organization
Organization Name:TWINSRX LLC
Other - Org Name:KEYSTONE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST MANAGER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLAVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-668-2284
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-0042
Mailing Address - Country:US
Mailing Address - Phone:412-646-2619
Mailing Address - Fax:412-646-4134
Practice Address - Street 1:106 PENN PLZ
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1914
Practice Address - Country:US
Practice Address - Phone:412-646-2619
Practice Address - Fax:412-646-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
PAPP4826993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166950OtherPK
PA1029959720002Medicaid