Mainline Pharmacy Murrysville, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410755L Issued in PA

Legal business name

MAINLINE PHARMACY MURRYSVILLE, LLC

Doing business as

Mainline Pharmacy Murrysville

Practice address

3907 Old William Penn Hwy
Murrysville, PA 15668-1833

Phone

(724) 327-6611

Fax

(724) 327-5814

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Steven Joseph Decriscio

Title

Cfo

Phone

(814) 408-6800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mainline Pharmacy Murrysville Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• William Penn Care Center

  • Skilled Nursing Facility
  • Jeannette, PA
  • NPI 1235168519

  Limited Partnership Interest

  CMS ownership

Practitioners 3

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
• Jack Moschgat, PHARMD

  • Pharmacist
  • Portage, PA
  • NPI 1275984478
  NPD
• John Pastorek

  • Pharmacist
  • Indiana, PA
  • NPI 1013396167
  NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1326106444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 OLD WILLIAM PENN HWY",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681833",
            "telephone_number": "724-327-6611",
            "fax_number": "724-327-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 OLD WILLIAM PENN HWY",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681833",
            "telephone_number": "724-327-6611",
            "fax_number": "724-327-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE PHARMACY MURRYSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "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"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410755L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103992760-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mainline Pharmacy Murrysville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gerald Thomas Loyacona, D.M.D,
• Ellen Lu, MD
• Sydney Gober Lucas, LPC-S
• Emily Lunt, LSW
• Laurene L Madine, M.S.W., L.C.S.W.
• Mayra Johanna Manchego
• Jennifer L March, MPT
• Marsalese Chiropractic Offices PC
• Jeffrey K Marsalese, DC, DACBN, CCN
• Loriann M Massarelli, LCSW

• Community/Retail Pharmacy in Murrysville, PA
• Providers in Murrysville, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.