Individual provider Active NPI

Dominick Dilucente

  • Pharmacist
  • North Versailles, PA
National Provider Identifier
1073113452
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP451859 Issued in PA
Practice address
100 Walmart Dr Ste 1
North Versailles, PA 15137-1533
Phone
(412) 816-0307
Fax
(412) 816-0368
NPI assigned
Oct 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP451859 PA Primary

Addresses

Primary practice location

100 Walmart Dr Ste 1
North Versailles, PA 15137-1533

Mailing address

100 Walmart Dr Ste 1
North Versailles, PA 15137-1533
Phone (412) 816-0307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP451859PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1073113452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALMART DR STE 1",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151371533",
            "telephone_number": "412-816-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WALMART DR STE 1",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151371533",
            "telephone_number": "412-816-0307",
            "fax_number": "412-816-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILUCENTE",
        "first_name": "DOMINICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP451859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Versailles, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.