| NPI | 1184993040 |
|---|---|
| Doing Business As | MAINLINE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | STEVEN JOSEPH DECRISCIO CFO 814-408-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP412694L) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 174H00000X Health Educator | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2022-04-26 |