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General NPI Number Information
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NPI Number | 1659369213
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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 | 10/07/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1414 EOFF ST
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City | WHEELING
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State | WV
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Zip | 26003-3526
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Country | US
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Telephone | 304-233-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 EOFF ST
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City | WHEELING
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State | WV
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Zip | 26003-3526
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Country | US
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Telephone | 304-233-3010
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/ OWNER
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Name | MR. ANTHONY DECARIA
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Credential | RPH
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Telephone | 330-385-0825
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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 | SP0550467
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License Number State | WV
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