Mainline Cpl, LLC
NPI #1770638702 in Portage, Pennsylvania
Provider Information
- NPI Number
- 1770638702
- Entity Type
- Organization
- Organization Name
- Mainline Cpl, LLC
- Primary Specialty
- Pharmacy
- Enumeration Date
- Jan 23, 2007
- Last Updated
- Apr 27, 2022
Practice Location
- Address
- 619 MAIN ST
- City
- Portage
- State
- Pennsylvania
- ZIP Code
- 15946-1539
- Phone
- (814) 736-4530
Authorized Official
- Name
- MR. STEVEN JOSEPH DECRISCIO
- Title
- CFO
- Phone
- (814) 408-6800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
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