Mainline CPL, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PP481858 Issued in PA

Legal business name

MAINLINE CPL, LLC

Doing business as

MAINLINE LTC PHARMACY

Practice address

1049 Shoemaker St Ste 2
Nanty Glo, PA 15943-1248

Phone

(814) 736-3044

Fax

(814) 736-9522

NPI assigned

Sep 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Steven Joseph Decriscio

Title

Cfo

Phone

(814) 408-6800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MAINLINE LTC PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerald Michael Moschgat, RPH

  • Pharmacist
  • Portage, PA
  • NPI 1154650851
  NPD (past)
• Jeffrey Moschgat, PHARMD

  • Pharmacist
  • Portage, PA
  • NPI 1457702656
  NPD (past)

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1124352760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 SHOEMAKER ST STE 2",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431248",
            "telephone_number": "814-736-3044",
            "fax_number": "814-736-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 SHOEMAKER ST STE 2",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431248",
            "telephone_number": "814-736-3044",
            "fax_number": "814-736-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE CPL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "DECRISCIO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-408-6800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "PP481858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE",
            "identifier": "PP481858",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAINLINE LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAINLINE LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Janosik
• Daniel W Johnson, MD
• Mark Lauffer, DC
• Daniel James Leonard III, M.D.
• Mainline Compounding & Infusion Pharmacy LLC
• Mainline Pharmacy Ebensburg, LLC
• Kimberly Ann Myers, RPH
• Rite Aid of Pennsylvania LLC
• Stephen Rodrigues, PRESIDENT/CEO
• Larry James Rupert

• Long Term Care Pharmacy in Nanty Glo, PA
• Providers in Nanty Glo, PA by specialty
• Long Term Care Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.