Provider Demographics
NPI:1992560924
Name:DECARIA BROTHERS INC
Entity type:Organization
Organization Name:DECARIA BROTHERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DECARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-385-0825
Mailing Address - Street 1:104 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-3031
Mailing Address - Country:US
Mailing Address - Phone:330-385-0825
Mailing Address - Fax:330-385-8415
Practice Address - Street 1:104 E 5TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3031
Practice Address - Country:US
Practice Address - Phone:330-385-0825
Practice Address - Fax:330-385-8415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECARIA BROTHERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy