Provider Demographics
NPI:1326403643
Name:VALUE SPECIALTY PHARMACY LLC
Entity type:Organization
Organization Name:VALUE SPECIALTY PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-265-8008
Mailing Address - Street 1:PO BOX 645336
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-5251
Mailing Address - Country:US
Mailing Address - Phone:855-265-8008
Mailing Address - Fax:814-283-2211
Practice Address - Street 1:4200 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-1737
Practice Address - Country:US
Practice Address - Phone:855-265-8008
Practice Address - Fax:814-283-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 3336L0003X
PAPP4821503336C0003X
MD220953336C0003X
WVMO05603463336C0003X
KYPA19913336C0003X
DEA9-00010903336C0003X
NJ28RO000720003336C0003X
VA02140014103336C0003X
NY0312683336C0003X
OHNRP.022200300033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026644790001Medicaid
2157273OtherPK
6664460001Medicare NSC