Provider Demographics
NPI:1659449619
Name:ALLEGHENY COUNTY
Entity Type:Organization
Organization Name:ALLEGHENY COUNTY
Other - Org Name:KANE REGIONAL CTR GLEN HAZEL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BABU
Authorized Official - Middle Name:
Authorized Official - Last Name:SRINIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-422-6904
Mailing Address - Street 1:955 RIVERMONT DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1347
Mailing Address - Country:US
Mailing Address - Phone:412-422-6050
Mailing Address - Fax:412-422-6966
Practice Address - Street 1:955 RIVERMONT DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-1347
Practice Address - Country:US
Practice Address - Phone:412-422-6050
Practice Address - Fax:412-422-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3946716OtherNABP
PA0009363430005Medicaid
PAHP-418354LOtherPHARMACY LICENSE
PAHP-418354LOtherPHARMACY LICENSE