Healthcare Provider Details

I. General information

NPI: 1740262518
Provider Name (Legal Business Name): BUCHANAN BROTHERS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W MAIN ST
WESTFIELD PA
16950-1522
US

IV. Provider business mailing address

122 W MAIN ST
WESTFIELD PA
16950-1522
US

V. Phone/Fax

Practice location:
  • Phone: 814-367-2327
  • Fax: 814-367-5197
Mailing address:
  • Phone: 814-367-2327
  • Fax: 814-367-5197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP411741L
License Number StatePA

VIII. Authorized Official

Name: MR. JOSEPH N MARZO JR.
Title or Position: PRESIDENT
Credential: RPH
Phone: 814-274-8660