Healthcare Provider Details
I. General information
NPI: 1679567200
Provider Name (Legal Business Name): US COMPLETE CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 RAILROAD ST
ST MARYS PA
15857-1729
US
IV. Provider business mailing address
10 RAILROAD ST
ST MARYS PA
15857-1729
US
V. Phone/Fax
- Phone: 814-781-3192
- Fax: 814-781-3192
- Phone: 814-781-3192
- Fax: 814-781-3192
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | PP414576L |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
FRANCIS
XAVIER
STRAUB
III
Title or Position: PRESIDENT
Credential: RPH
Phone: 814-781-3192