Provider Demographics
NPI:1760248066
Name:DECARIA BROTHERS INC
Entity Type:Organization
Organization Name:DECARIA BROTHERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DECARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-385-0825
Mailing Address - Street 1:4201 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-3629
Mailing Address - Country:US
Mailing Address - Phone:740-264-5711
Mailing Address - Fax:740-264-4755
Practice Address - Street 1:4201 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-3629
Practice Address - Country:US
Practice Address - Phone:740-264-5711
Practice Address - Fax:740-264-4755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECARIA BROTHERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy