Provider Demographics
NPI:1134231145
Name:MEDICAP PHARMACY
Entity type:Organization
Organization Name:MEDICAP PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAPANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-821-1524
Mailing Address - Street 1:225 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:MILLVALE
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 GRANT AVE
Practice Address - Street 2:
Practice Address - City:MILLVALE
Practice Address - State:PA
Practice Address - Zip Code:15209-2609
Practice Address - Country:US
Practice Address - Phone:412-821-1524
Practice Address - Fax:412-821-1528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414136L333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3956731OtherNCPDP #
3956731OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA0011499050001Medicaid
PABM1695999OtherDEA #
PA0011499050001Medicaid