Provider Demographics
NPI:1548018393
Name:GENE A RILEY & THOMAS C RILEY PTRS
Entity type:Organization
Organization Name:GENE A RILEY & THOMAS C RILEY PTRS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RPH, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-344-6700
Mailing Address - Street 1:300 MOUNT LEBANON BLVD STE 23
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1506
Mailing Address - Country:US
Mailing Address - Phone:412-344-6700
Mailing Address - Fax:412-344-5223
Practice Address - Street 1:300 MOUNT LEBANON BLVD STE 23
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1506
Practice Address - Country:US
Practice Address - Phone:412-344-6700
Practice Address - Fax:412-344-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0918425Medicaid