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General NPI Number Information
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NPI Number | 1306827746
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Entity Type | Organization
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Legal Business Name | CARUSO DRUG STORE INC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 323 BROAD ST
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City | NEW BETHLEHEM
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State | PA
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Zip | 16242-1003
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Country | US
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Telephone | 814-275-1156
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Fax | 814-275-4798
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Provider Business Mailing Address
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Address Line | 323 BROAD ST
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City | NEW BETHLEHEM
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State | PA
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Zip | 16242-1003
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Country | US
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Telephone | 814-275-1156
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Fax | 814-275-4798
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. AUTOINETTE ASTORI CARUSO
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Credential |
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Telephone | 814-275-1156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP412141L
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License Number State | PA
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