Provider Demographics
NPI:1942764071
Name:T E P INC
Entity Type:Organization
Organization Name:T E P INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-889-2311
Mailing Address - Street 1:525 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15066-1737
Mailing Address - Country:US
Mailing Address - Phone:724-847-7979
Mailing Address - Fax:724-847-1774
Practice Address - Street 1:525 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:PA
Practice Address - Zip Code:15066-1737
Practice Address - Country:US
Practice Address - Phone:724-847-7979
Practice Address - Fax:724-847-1774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T E P INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011588240002Medicaid