Provider Demographics
NPI:1013046895
Name:DARLING APOTHECARY, LLC
Entity Type:Organization
Organization Name:DARLING APOTHECARY, LLC
Other - Org Name:THE PHARMACY AT UNION SQUARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:BRUNO
Authorized Official - Last Name:ZAFFINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:814-723-1743
Mailing Address - Street 1:36 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2016
Mailing Address - Country:US
Mailing Address - Phone:814-362-6200
Mailing Address - Fax:814-362-6208
Practice Address - Street 1:36 DAVIS ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2016
Practice Address - Country:US
Practice Address - Phone:814-362-6200
Practice Address - Fax:814-362-6208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DARLING APOTHECARY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-05
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP413806L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010471820001Medicaid
2085416OtherPK
PA1012412900008Medicaid