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NPI Code Detail

MEDICARE: MR. JOSEPH THOMAS DEGRABA JR. RPH

MEDICARE: MR. JOSEPH THOMAS DEGRABA JR. RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRP034654LPA

General Provider Information

NPI Number : 1326220724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH THOMAS DEGRABA JR. RPH
Provider Business Mailing Address
First Line : 7 FOREST DR
Second Line :
City : DALLAS
State : PA
Zip : 18612-9758
Country : US
Telephone Number : 570-675-1571
Fax Number :
Provider Business Practice Location Address
First Line : 225 OVERLOOK DR
Second Line :
City : PITTSTON
State : PA
Zip : 18640-1058
Country : US
Telephone Number : 570-655-1911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2007
Last Update Date : 11/28/2007

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