Provider Demographics
NPI:1649265240
Name:DARLING APOTHECARY, LLC
Entity type:Organization
Organization Name:DARLING APOTHECARY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-723-1743
Mailing Address - Street 1:114 EAST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16371-4408
Mailing Address - Country:US
Mailing Address - Phone:814-563-3400
Mailing Address - Fax:814-563-3407
Practice Address - Street 1:114 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16371-4408
Practice Address - Country:US
Practice Address - Phone:814-563-3400
Practice Address - Fax:814-563-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP481342333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012412900007Medicaid
PA1008883740001Medicaid