Provider Demographics
NPI:1386105658
Name:MASCIO, GEORGE LEROY (RPH)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:LEROY
Last Name:MASCIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 ADMIRAL PEARY HWY
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4502
Mailing Address - Country:US
Mailing Address - Phone:610-316-0427
Mailing Address - Fax:
Practice Address - Street 1:2423 BETTS AVENUE
Practice Address - Street 2:INSIDE KEN'S BILO
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714
Practice Address - Country:US
Practice Address - Phone:814-420-8551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032404L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist