Organization
CENTERVILLE CLINICS , INC.
Active
Organization
CENTERVILLE CLINICS , INC.
Active
Other names
CENTERVILLE CLINICS WASHINGTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY R NICCOLAI (CEO)
(724) 632-6801
Entity
Organization
Contact information
Practice address
37 HIGHLAND AVE, WASHINGTON, PA 15301-4062
(878) 218-1844
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728844-0149
—
PA
Enumeration date
07/16/2024
Last updated
05/29/2025
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