Provider Demographics
NPI:1851580161
Name:ADVANCED PHARMACY INC
Entity Type:Organization
Organization Name:ADVANCED PHARMACY INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-481-2400
Mailing Address - Street 1:20 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1728
Mailing Address - Country:US
Mailing Address - Phone:412-481-2400
Mailing Address - Fax:412-481-9310
Practice Address - Street 1:20 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15211-1728
Practice Address - Country:US
Practice Address - Phone:412-481-2400
Practice Address - Fax:412-481-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020524660001Medicaid
PA3989172OtherNCPDP #
PAFT0608034OtherDEA #
PA120225Medicare PIN
PA6049280001Medicare NSC