Provider Demographics
NPI:1033223680
Name:JOSEPH F. DELLANTONIO, INC.
Entity Type:Organization
Organization Name:JOSEPH F. DELLANTONIO, INC.
Other - Org Name:CLEARFIELD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP. SECRETARY / BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHICKLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-765-7841
Mailing Address - Street 1:307 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-2432
Mailing Address - Country:US
Mailing Address - Phone:814-765-7841
Mailing Address - Fax:814-765-5827
Practice Address - Street 1:307 E MARKET ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-2432
Practice Address - Country:US
Practice Address - Phone:814-765-7841
Practice Address - Fax:814-765-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413006L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3955157OtherNAPB#
PA1007289330008Medicaid
PA1007289330008Medicaid