Active NPI
Larry James Rupert
- Pharmacist
- Nanty Glo, PA
National Provider Identifier
1124673496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP453593
- Practice address
- 1049 Shoemaker St
Nanty Glo, PA 15943-1248 - Phone
- (814) 419-6717
- NPI assigned
- Aug 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453593 | PA | Primary |
Addresses
Primary practice location
1049 Shoemaker St
Nanty Glo, PA 15943-1248
Mailing address
118 Schoolhouse Rd
New Florence, PA 15944-2513
Phone (724) 464-4341
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP453593 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainline Pharmacy Ebensburg LLC | Past | Accepting new patients | |
| Mainline Pharmacy Ebensburg, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Ebensburg, PA
- NPI 1184993040
-
- Community/Retail Pharmacy
- Nanty Glo, PA
- NPI 1235539800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1124673496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 SCHOOLHOUSE RD",
"city": "NEW FLORENCE",
"state": "PA",
"postal_code": "159442513",
"telephone_number": "724-464-4341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1049 SHOEMAKER ST",
"city": "NANTY GLO",
"state": "PA",
"postal_code": "159431248",
"telephone_number": "814-419-6717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPERT",
"first_name": "LARRY",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP453593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nanty Glo, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.