Provider Demographics
NPI:1336599562
Name:WASHINGTON CARE PHARMACY
Entity type:Organization
Organization Name:WASHINGTON CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAVEENDRANATH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-206-9432
Mailing Address - Street 1:95 LEONARD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-206-9432
Mailing Address - Fax:
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:412-351-5128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-19
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy