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General NPI Number Information
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NPI Number | 1144225095
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Entity Type | Organization
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Legal Business Name | DECARIA BROTHERS INC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 1429 BURGETTSTOWN PLZ
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City | BURGETTSTOWN
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State | PA
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Zip | 15021-1187
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Country | US
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Telephone | 724-947-7000
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Fax | 724-947-5699
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Provider Business Mailing Address
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Address Line | 1429 BURGETTSTOWN PLZ
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City | BURGETTSTOWN
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State | PA
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Zip | 15021-1187
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Country | US
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Telephone | 724-947-7000
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Fax | 724-947-5699
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD DECARIA
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Credential |
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Telephone | 412-264-2230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP413903L
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License Number State | PA
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