Provider Demographics
NPI:1942034376
Name:DECARIA BROTHERS INC
Entity type:Organization
Organization Name:DECARIA BROTHERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ANDRESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-317-4282
Mailing Address - Street 1:935 BEAVER GRADE RD
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2747
Mailing Address - Country:US
Mailing Address - Phone:412-264-2230
Mailing Address - Fax:412-264-9497
Practice Address - Street 1:935 BEAVER GRADE RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2747
Practice Address - Country:US
Practice Address - Phone:412-264-2230
Practice Address - Fax:412-264-9497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy