MEDICARE: DISBRO DRUGS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	60003038A	IN

General Provider Information

NPI Number	:	1992781314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISBRO DRUGS INC

Provider Business Mailing Address
First Line	:	2307 CYPRESS PT
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-6775
Country	:	US
Telephone Number	:	812-282-6275
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 S INDIANA AVE
Second Line	:
City	:	SELLERSBURG
State	:	IN
Zip	:	47172-1532
Country	:	US
Telephone Number	:	812-246-3421
Fax Number	:	812-246-3481

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	MR. STEPHEN M DISBRO
Credential	:	RPH
Telephone Number	:	812-246-3421

Provider Enumeration Date	:	12/17/2005
Last Update Date	:	08/22/2020

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