Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Other names
Brockway Drug Co
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BENNETT (DIRECTOR OF RETAIL PHARMACY)
(814) 299-7553
Entity
Organization
Contact information
Practice address
1365 MAIN ST, BROCKWAY, PA 15824-1635
(814) 268-3305
(814) 265-1143
Mailing address
1365 MAIN ST, BROCKWAY, PA 15824-1635
(814) 268-3305
(814) 265-1143
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PP410257L
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP410257L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006339800002
—
PA
01
—
3915482
NABP NUMBER
—
Enumeration date
08/03/2006
Last updated
10/13/2022
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