Healthcare Provider Details

I. General information

NPI: 1417263229
Provider Name (Legal Business Name): ANTHONY DOM CALABRO R. PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CLAY PIKE
NORTH HUNTINGDON PA
15642-2039
US

IV. Provider business mailing address

726 GRANT ST
IRWIN PA
15642-3621
US

V. Phone/Fax

Practice location:
  • Phone: 724-863-2350
  • Fax:
Mailing address:
  • Phone: 724-864-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP026025L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: