Provider Demographics
NPI:1013987171
Name:CHARLES AMBRASS INC
Entity Type:Organization
Organization Name:CHARLES AMBRASS INC
Other - Org Name:TROY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMBRASS
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-231-1559
Mailing Address - Street 1:1612 LOWRIE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4332
Mailing Address - Country:US
Mailing Address - Phone:412-231-1559
Mailing Address - Fax:412-231-2759
Practice Address - Street 1:1612 LOWRIE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4332
Practice Address - Country:US
Practice Address - Phone:412-231-1559
Practice Address - Fax:412-231-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA413956333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3954282OtherNCPDP