Provider Demographics
NPI:1831815273
Name:PIPAK ENTERPRISE
Entity type:Organization
Organization Name:PIPAK ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:PIPAK
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:330-782-8101
Mailing Address - Street 1:5106 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2107
Mailing Address - Country:US
Mailing Address - Phone:330-782-8101
Mailing Address - Fax:330-782-7744
Practice Address - Street 1:5106 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-2107
Practice Address - Country:US
Practice Address - Phone:330-782-8101
Practice Address - Fax:330-782-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0186150Medicaid