Provider Demographics
NPI:1871914473
Name:SPECIALTY PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:SPECIALTY PHARMACY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MESHANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-547-1989
Mailing Address - Street 1:445 W MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1533
Mailing Address - Country:US
Mailing Address - Phone:724-547-1989
Mailing Address - Fax:724-542-4148
Practice Address - Street 1:445 W MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1533
Practice Address - Country:US
Practice Address - Phone:724-547-1989
Practice Address - Fax:724-542-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
PAPP4816843336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2143546OtherPK