Provider Demographics
NPI:1891423299
Name:UPMC COMMUNITY PROVIDER SERVICES
Entity Type:Organization
Organization Name:UPMC COMMUNITY PROVIDER SERVICES
Other - Org Name:UPMC PASSAVANT OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-2940
Mailing Address - Street 1:200 OLD POND RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1269
Mailing Address - Country:US
Mailing Address - Phone:412-328-4788
Mailing Address - Fax:412-221-0412
Practice Address - Street 1:9100 BABCOCK BLVD FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5815
Practice Address - Country:US
Practice Address - Phone:412-748-4610
Practice Address - Fax:412-748-4611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC COMMUNITY PROVIDER SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-12
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy