Provider Demographics
NPI:1013756998
Name:WILSON'S PHARMACY
Entity type:Organization
Organization Name:WILSON'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-621-6471
Mailing Address - Street 1:4101 PENN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1326
Mailing Address - Country:US
Mailing Address - Phone:412-621-6471
Mailing Address - Fax:412-621-6977
Practice Address - Street 1:4101 PENN AVE STE A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1326
Practice Address - Country:US
Practice Address - Phone:412-621-6471
Practice Address - Fax:412-621-6977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILSON'S PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy