Provider Demographics
NPI:1689688491
Name:BILO PHARMACY
Entity Type:Organization
Organization Name:BILO PHARMACY
Other - Org Name:BILO FOODS AND PHARMACY 9231
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SYSTEMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ERBA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-461-2595
Mailing Address - Street 1:ROUTE 255 SANDY PLAZA
Mailing Address - Street 2:
Mailing Address - City:DUBOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 255 SANDY PLAZA
Practice Address - Street 2:
Practice Address - City:DUBOIS
Practice Address - State:PA
Practice Address - Zip Code:15801
Practice Address - Country:US
Practice Address - Phone:814-375-3723
Practice Address - Fax:814-371-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414747L333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007783900027Medicaid
3966439OtherOTHER ID NUMBER-COMMERCIAL NUMBER