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General NPI Number Information
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NPI Number | 1780666552
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Entity Type | Organization
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Legal Business Name | BUCHANAN BROTHERS PHARMACY INC
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 170 MAIN ST
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City | ELDRED
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State | PA
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Zip | 16731-4522
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Country | US
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Telephone | 814-225-4723
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Fax | 814-225-4724
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Provider Business Mailing Address
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Address Line | 170 MAIN ST
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City | ELDRED
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State | PA
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Zip | 16731-4522
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Country | US
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Telephone | 814-225-4723
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Fax | 814-225-4724
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH N MARZO JR.
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Credential | RPH
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Telephone | 814-274-8660
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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 | PP410940L
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License Number State | PA
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