NPIMap

Organization Active NPI

Debalkos Pharmacy Inc

Doing business as Standard Drug

  • Prosthetic/Orthotic Supplier
  • McAdoo, PA
National Provider Identifier
1063465383
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
PP412373L Issued in PA
Legal business name
DEBALKOS PHARMACY INC
Doing business as
Standard Drug
Practice address
322 S Hancock St
McAdoo, PA 18237-1608
Phone
(570) 929-1130
Fax
(570) 929-1208
NPI assigned
May 18, 2006
Last updated
May 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Nicholas Debalko, RPH PHARMDNPI 1366449936
Title
President
Phone
(570) 929-2028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PP412373L PA
Prosthetic/Orthotic Supplier 335E00000X PP412373L PA Primary

Addresses

Primary practice location

322 S Hancock St
McAdoo, PA 18237-1608

Mailing address

322 S Hancock St
McAdoo, PA 18237-1608
Phone (570) 929-1130

Other identifiers 3

IdentifierTypeStateIssuer
237105OtherPAPA BS DME
001017817MedicaidPA
39HA85OtherPACAPITAL BC DME

Other names 1

  • Standard Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050823000136 PA Part B Supplier - Mass Immunization (Roster Biller Only) 7416988191 Practice locations: McAdoo, PA

National Provider Directory

National Provider Directory

Locations

322 S Hancock St
McAdoo, PA 18237
Phone (570) 929-1130

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1063465383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 S HANCOCK ST",
            "city": "MCADOO",
            "state": "PA",
            "postal_code": "182371608",
            "telephone_number": "570-929-1130",
            "fax_number": "570-929-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 S HANCOCK ST",
            "city": "MCADOO",
            "state": "PA",
            "postal_code": "182371608",
            "telephone_number": "570-929-1130",
            "fax_number": "570-929-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBALKOS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "DEBALKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-929-2028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPH PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP412373L",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "PP412373L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BS DME",
            "identifier": "237105",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017817",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC DME",
            "identifier": "39HA85",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Standard Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McAdoo, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.