Organization
DEPIETROS PHARMACY LLC
Active
Other names
DePietros Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DEPIETRO (PHARMACY MANAGER/OWNER)
(570) 209-7440
Entity
Organization
Contact information
Practice address
617 3RD ST, DUNMORE, PA 18512-2849
(570) 209-7440
(570) 209-7442
Mailing address
617 3RD ST, DUNMORE, PA 18512-2849
(570) 209-7440
(570) 209-7442
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482235
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3996646
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/12/2012
Last updated
10/30/2012
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