Provider Demographics
NPI:1730340258
Name:LOPEZ, MARCOS (CLINICAL PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:MARCOS
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:CLINICAL PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 LONG RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4045
Mailing Address - Country:US
Mailing Address - Phone:707-816-8622
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS PITTSBURGH MEDICAL CENTER
Practice Address - Street 2:4100 ALLEQUIPPA STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-360-2449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4679183500000X, 1835P0018X
PARP4452521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist