Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
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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