Provider Demographics
NPI:1104056522
Name:SPARTAN PHARMACY INC.
Entity type:Organization
Organization Name:SPARTAN PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:R PH, PHARM D
Authorized Official - Phone:412-884-5650
Mailing Address - Street 1:3526 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3116
Mailing Address - Country:US
Mailing Address - Phone:412-884-5650
Mailing Address - Fax:412-884-5651
Practice Address - Street 1:3528 BROWNSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227
Practice Address - Country:US
Practice Address - Phone:412-885-4700
Practice Address - Fax:412-592-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4819373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy