Provider Demographics
NPI:1699044776
Name:STRAUB, BRIAN T (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:STRAUB
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 VINE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-2035
Mailing Address - Country:US
Mailing Address - Phone:814-335-8680
Mailing Address - Fax:
Practice Address - Street 1:903 NISSLEY RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1472
Practice Address - Country:US
Practice Address - Phone:717-406-2226
Practice Address - Fax:866-891-7887
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist