Provider Demographics
NPI:1235968363
Name:AZMAJT RETAIL PHARMACY, LLC
Entity type:Organization
Organization Name:AZMAJT RETAIL PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OHARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-498-0730
Mailing Address - Street 1:1 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1301
Mailing Address - Country:US
Mailing Address - Phone:724-745-6480
Mailing Address - Fax:724-916-4957
Practice Address - Street 1:1 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1301
Practice Address - Country:US
Practice Address - Phone:724-745-6480
Practice Address - Fax:724-916-4957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy