NPIMap

Organization Active NPI

Decaria Brothers Inc

  • Long Term Care Pharmacy
  • E Liverpool, OH
National Provider Identifier
1316935976
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
021473300 Issued in OH
Legal business name
DECARIA BROTHERS INC
Practice address
104 E 5TH St # 2
E Liverpool, OH 43920-3031
Phone
(330) 385-6339
Fax
(330) 385-1400
NPI assigned
Oct 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Authorized official

Name
Erin Mader, PHARMDNPI 1124219829
Title
Dir of Clinical SVCS
Phone
(330) 385-6339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 021473300 OH Primary

Addresses

Primary practice location

104 E 5TH St # 2
E Liverpool, OH 43920-3031

Mailing address

104 E 5TH St # 2
E Liverpool, OH 43920-3031
Phone (330) 385-6339

Other identifiers 2

IdentifierTypeStateIssuer
2079957OtherPK
2516129MedicaidOH

Other names 1

  • MEDICAL EXPRESS PHARMACY SERVICES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930068475 OH DME Supplier - Pharmacy 8426085861 Practice locations: East Liverpool, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Decaria Brothers Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 E 5th St
#2
East Liverpool, OH 43920
Phone (330) 385-6339

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1316935976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 5TH ST # 2",
            "city": "E LIVERPOOL",
            "state": "OH",
            "postal_code": "439203031",
            "telephone_number": "330-385-6339",
            "fax_number": "330-385-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E 5TH ST # 2",
            "city": "E LIVERPOOL",
            "state": "OH",
            "postal_code": "439203031",
            "telephone_number": "330-385-6339",
            "fax_number": "330-385-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECARIA BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "MADER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "DIR OF CLINICAL SVCS",
        "authorized_official_telephone_number": "330-385-6339",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OH",
            "license": "021473300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079957",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2516129",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL EXPRESS PHARMACY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in E Liverpool, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.

Verify at the official NPI Registry.