Provider Demographics
NPI:1730291394
Name:JOSEPH DI MATTEO INC
Entity Type:Organization
Organization Name:JOSEPH DI MATTEO INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-798-9800
Mailing Address - Street 1:12238 FRANKSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3404
Mailing Address - Country:US
Mailing Address - Phone:412-798-9800
Mailing Address - Fax:412-798-4572
Practice Address - Street 1:12238 FRANKSTOWN RD
Practice Address - Street 2:
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-3404
Practice Address - Country:US
Practice Address - Phone:412-798-9800
Practice Address - Fax:412-798-4572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411951L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3940245OtherNCPDP NUMBER
PA0005599360002Medicaid
PA0005599360002Medicaid
PA0674100001Medicare NSC
PA121945Medicare PIN