Provider Demographics
NPI:1265183271
Name:LAVELLA PHARMACIES LLC
Entity type:Organization
Organization Name:LAVELLA PHARMACIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:412-427-5155
Mailing Address - Street 1:114 HARDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-2318
Mailing Address - Country:US
Mailing Address - Phone:412-427-5155
Mailing Address - Fax:
Practice Address - Street 1:818 E WARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-1560
Practice Address - Country:US
Practice Address - Phone:412-431-5766
Practice Address - Fax:412-431-2568
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAVELLA PHARMACIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-11
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031423990001Medicaid