Provider Demographics
NPI:1891867685
Name:PHIL PATA II
Entity Type:Organization
Organization Name:PHIL PATA II
Other - Org Name:SAVE RITE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,PIC,AO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-676-3433
Mailing Address - Street 1:3235 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1520
Mailing Address - Country:US
Mailing Address - Phone:740-676-3433
Mailing Address - Fax:740-676-3435
Practice Address - Street 1:3235 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1520
Practice Address - Country:US
Practice Address - Phone:740-676-3433
Practice Address - Fax:740-676-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHRTP.021612600-033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7724501Medicaid
2075161OtherPK
2075161OtherPK