Organization
INDEPENDENT PHARMACY GROUP INC
Active
Other names
BEL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ANTHONY PETRACCI REG PHARM (PHARMACIST AND OWNER)
(330) 746-2657
Entity
Organization
Contact information
Practice address
602 PARMALEE AVE, STE 100, YOUNGSTOWN, OH 44510-1653
(330) 746-2657
(330) 746-0014
Mailing address
602 PARMALEE AVE, SUITE 100, YOUNGSTOWN, OH 44510-1653
(330) 746-2657
(330) 746-0014
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0952992
—
OH
01
—
3643764
OTHER ID NUMBER
—
Enumeration date
03/30/2007
Last updated
10/05/2007
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