Mainline Pharmacy

LBN: Mainline Pharmacy Ebensburg, Llc
Mainline Pharmacy is an health care organization with primary practice located at 1049 Shoemaker St Ste 1 , Nanty Glo PA 15943-1248. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mainline Pharmacy Ebensburg, Llc can be contacted via phone (814) 419-6717, or through Decriscio, Steven J via phone (814) 408-6800.

Contact Information

Primary practice address
1049 Shoemaker St Ste 1 Nanty Glo PA 15943-1248
Phone: (814) 419-6717
Fax: (814) 419-6719
Website:
Map and Directions
Authorized official contact:
Name: Decriscio, Steven J
Phone: (814) 408-6800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X Pennsylvania
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1235539800
LBN Legal business name Mainline Pharmacy Ebensburg, Llc
DBA Doing business as Mainline Pharmacy
Authorized official Decriscio, Steven J
Entity Organization
Organization subpart 1 No
Enumeration date Sep 2nd, 2014
Last updated Jun 8th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235539800 NPPES
Pennsylvania MEDICAID 102691494-0002

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