Healthcare Provider Details

I. General information

NPI: 1891780797
Provider Name (Legal Business Name): A & G PHARMACY SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2665 BRODHEAD RD SUITE B
ALIQUIPPA PA
15001-2723
US

IV. Provider business mailing address

2665 BRODHEAD RD SUITE B
ALIQUIPPA PA
15001-2723
US

V. Phone/Fax

Practice location:
  • Phone: 724-375-1230
  • Fax:
Mailing address:
  • Phone: 724-375-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP414481L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANTONIETTE ALFONSINA BARBUTO
Title or Position: OWNER/MANAGER/PHARMACIST
Credential: RPH
Phone: 724-375-1230