Provider Demographics
NPI:1831297860
Name:COMMUNITY DRUG
Entity Type:Organization
Organization Name:COMMUNITY DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRHOGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-421-4104
Mailing Address - Street 1:517 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:517 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-1051
Practice Address - Country:US
Practice Address - Phone:412-421-4104
Practice Address - Fax:412-521-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410823L333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3932767OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA0011780860001Medicaid
3932767OtherOTHER ID NUMBER-COMMERCIAL NUMBER