Healthcare Provider Details

I. General information

NPI: 1124344262
Provider Name (Legal Business Name): DARLING APOTHECARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MAIN ST
TIDIOUTE PA
16351-1062
US

IV. Provider business mailing address

212 LIBERTY ST
WARREN PA
16365-2347
US

V. Phone/Fax

Practice location:
  • Phone: 814-484-7777
  • Fax: 814-484-2760
Mailing address:
  • Phone: 814-723-1743
  • Fax: 814-726-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP482048
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DARLING
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 814-484-7777