Organization
DEBALKOS PHARMACY INC
Active
Other names
Standard Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN NICHOLAS DEBALKO RPH PHARMD (PRESIDENT)
(570) 929-2028
Entity
Organization
Contact information
Practice address
322 S HANCOCK ST, MCADOO, PA 18237-1608
(570) 929-1130
(570) 929-1208
Mailing address
322 S HANCOCK ST, MCADOO, PA 18237-1608
(570) 929-1130
(570) 929-1208
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PP412373L
PA
335E00000X
Prosthetic/Orthotic Supplier
Primary
PP412373L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001017817
—
PA
01
—
237105
PA BS DME
PA
01
—
39HA85
CAPITAL BC DME
PA
Enumeration date
05/18/2006
Last updated
05/04/2012
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