Active NPI
Michael Vito Fornataro, RPH
- Pharmacist
- New Castle, PA
National Provider Identifier
1295873750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP036614L
- Practice address
- 708 E Washington St
New Castle, PA 16101-4137 - Phone
- (724) 658-4557
- Fax
- (724) 658-4547
- NPI assigned
- Feb 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | RP036614L | PA | Primary |
Addresses
Primary practice location
708 E Washington St
New Castle, PA 16101-4137
Mailing address
708 E Washington St
New Castle, PA 16101-4137
Phone (724) 658-4557
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3937476 | Other | PA | NABP |
| 0019495420001 | Medicaid | PA |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP036614L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mikes Apothecary Inc | Past | Accepting new patients |
Organizations & group practices 1
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
- New Castle, PA
- NPI 1992920805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367539200000",
"number": "1295873750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 E WASHINGTON ST",
"city": "NEW CASTLE",
"state": "PA",
"postal_code": "161014137",
"telephone_number": "724-658-4557",
"fax_number": "724-658-4547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 E WASHINGTON ST",
"city": "NEW CASTLE",
"state": "PA",
"postal_code": "161014137",
"telephone_number": "724-658-4557",
"fax_number": "724-658-4547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNATARO",
"first_name": "MICHAEL",
"middle_name": "VITO",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-04",
"last_updated": "2013-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP036614L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "3937476",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019495420001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Castle, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.