Ryan Griesbaum
Individual provider Active NPI Pharmacist · Monaca, PA
NPI 1124476502 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1124476502
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 449982 (PA)
- Practice address
- 87 Wagner Rd
Monaca, PA 15061-2421 - Phone
- (724) 728-7259
- NPI assigned
- May 26, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028025 | GA | MD | Pharmacist |
| 3135423 | OH | MD | Pharmacist |
| 449982 | PA | MD | Pharmacist |
| 35644 | SC | MD | Pharmacist |
| 0009366 | WV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 028025 | GA | |
| Pharmacist | 183500000X | 0009366 | WV | |
| Pharmacist | 183500000X | 35644 | SC | |
| Pharmacist | 183500000X | 3135423 | OH | |
| Pharmacist | 183500000X | 449982 | PA | Yes |
Addresses
Primary practice location
87 Wagner Rd
Monaca, PA 15061-2421
Mailing address
87 Wagner Rd
Monaca, PA 15061-2421
Phone (724) 728-7259
Other providers in Monaca, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.