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General NPI Number Information
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NPI Number | 1720533243
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Entity Type | Organization
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Legal Business Name | BIANCARELLIS PHARMACY
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 1318 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2000
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Country | US
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Telephone | 570-382-8570
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Fax | 570-382-3478
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Provider Business Mailing Address
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Address Line | 1318 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2000
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Country | US
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Telephone | 570-382-8570
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Fax | 570-382-3478
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Authorized Official
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Title or Position | R.PH.
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Name | BRUCE BIANCARELLI
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Credential |
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Telephone | 570-382-8570
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP482657
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License Number State | PA
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