Active NPI
Decaria Brothers Inc
- Community/Retail Pharmacy
- Coraopolis, PA
National Provider Identifier
1164568770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PP411899L
- Legal business name
- DECARIA BROTHERS INC
- Practice address
- 935 Beaver Grade Rd
Coraopolis, PA 15108-2790 - Phone
- (412) 264-2230
- Fax
- (412) 264-9497
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward Decaria, RPH
- Title
- RPH Pharmacy Manager
- Phone
- (412) 264-2230
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PP411899L | PA | Primary |
Addresses
Primary practice location
935 Beaver Grade Rd
Coraopolis, PA 15108-2790
Mailing address
935 Beaver Grade Rd
Coraopolis, PA 15108-2790
Phone (412) 264-2230
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007478400003 | Medicaid | PA | |
| 2080179 | Other | PK | |
| 4360880008 | Other | PTAN |
Other names 1
- PORTERS PRESCRIPTION PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081006000647 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8426085861 |
1 other NPI on this enrollment Practice locations: Coraopolis, PA; Burgettstown, PA |
| O20150707002892 | PA | DME Supplier - Pharmacy | 8426085861 | Practice locations: Coraopolis, PA |
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1439424000000",
"number": "1164568770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 BEAVER GRADE RD",
"city": "CORAOPOLIS",
"state": "PA",
"postal_code": "151082790",
"telephone_number": "412-264-2230",
"fax_number": "412-264-9497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 BEAVER GRADE RD",
"city": "CORAOPOLIS",
"state": "PA",
"postal_code": "151082790",
"telephone_number": "412-264-2230",
"fax_number": "412-264-9497"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DECARIA BROTHERS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-30",
"last_updated": "2015-08-13",
"status": "A",
"authorized_official_last_name": "DECARIA",
"authorized_official_first_name": "EDWARD",
"authorized_official_title_or_position": "RPH PHARMACY MANAGER",
"authorized_official_telephone_number": "412-264-2230",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "PA",
"license": "PP411899L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007478400003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2080179",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "4360880008",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "PORTERS PRESCRIPTION PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coraopolis, PA
- Jessica Ann Davis, PHD, RN, CCRN, IBCLC
- Sandra Susanne Davis
- Danielle Marie Dawgiello, LPC
- Sydney Rose Debo
- Samantha Debone, PA-C
- Decaria Brothers Inc
- Decaria Brothers Inc
- Dental Professionals of Pennsylvania, P.C.
- Dermatology Associates of Western Pennsylvania Inc.
- Dermatology Associates of Western Pennsylvania Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.