Provider Demographics
NPI:1902267594
Name:THREE RIVERS MOTHERS' MILK BANK
Entity Type:Organization
Organization Name:THREE RIVERS MOTHERS' MILK BANK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-281-4400
Mailing Address - Street 1:3127 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-1421
Mailing Address - Country:US
Mailing Address - Phone:412-281-4400
Mailing Address - Fax:412-281-4236
Practice Address - Street 1:3127 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-1421
Practice Address - Country:US
Practice Address - Phone:412-281-4400
Practice Address - Fax:412-281-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies