Healthcare Provider Details

I. General information

NPI: 1609864289
Provider Name (Legal Business Name): DECARIA BROTHERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SUNSET BLVD
STEUBENVILLE OH
43952-3617
US

IV. Provider business mailing address

4201 SUNSET BLVD
STEUBENVILLE OH
43952-3617
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-5711
  • Fax:
Mailing address:
  • Phone: 740-264-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0714902
License Number StateOH

VIII. Authorized Official

Name: BRUNO A DECARIA
Title or Position: PHARMACIST/OWNER
Credential: RPH
Phone: 330-385-0825