Tyler Trutt

Individual provider Active NPI Pharmacist · Mt Pleasant Mills, PA

NPI 1205294147 · NPPES record last updated Feb 7, 2016

Key facts

NPI
1205294147
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RP441800 (PA)
Practice address
9627 Route 35 Ste 20
Mt Pleasant Mills, PA 17853-8409
Phone
(570) 539-2050
NPI assigned
Feb 7, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RP441800PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Trutt'S Pharmacy LLC Current Accepting new patients
Shade Mountain Pharmacy LLC Current Accepting new patients
Trutt'S Pharmacy LLC Current Accepting new patients

Locations

9627 Route 35
#20
Mt Pleasant Mills, PA 17853
Phone (570) 539-2050

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP441800 PA Yes

Addresses

Primary practice location

9627 Route 35 Ste 20
Mt Pleasant Mills, PA 17853-8409

Mailing address

9627 Route 35 Ste 20
Mt Pleasant Mills, PA 17853-8409
Phone (570) 539-2050

Other providers in Mt Pleasant Mills, PA

All providers in Mt Pleasant Mills, PA · Pharmacist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.