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Contact Information

BRACEYS SUPERMARKET INC.
ROUTE 502
DALEVILLE, PA18444
 Phone: 570-842-7848
 Fax: 570-842-2435
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BRACEYS SUPERMARKET INC.

NPI Number 1184728313
LBN Legal business name BRACEYS SUPERMARKET INC.
Authorized official MELISSA FIGUEROA RIVERA - (THIRD PARTY ADMINISTRATOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/08/2006
Last updated 03/30/2011 - About 15 years ago
Identifiers
PA License # PP415521L
PA Medicaid 0017474490001
PA Other 3975743 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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