NPIMap

Organization Active NPI

Decaria Brothers Inc.

  • Community/Retail Pharmacy
  • East Liverpool, OH
National Provider Identifier
1356561427
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-1815800 Issued in OH
Legal business name
DECARIA BROTHERS INC.
Practice address
15549 Ste Rte 170 Ste 1
Buckeye Pharmacy
East Liverpool, OH 43920
Phone
(330) 382-7726
Fax
(330) 382-7728
NPI assigned
Apr 30, 2007
Organization subpart
Yes
Parent organization
DECARIA BROTHERS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Vincent B Decaria
Title
Pharmacist- Owner
Phone
(330) 382-7726

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 02-1815800 OH
Community/Retail Pharmacy 3336C0003X 02-1815800 OH Primary
Long Term Care Pharmacy 3336L0003X 02-1815800 OH

Addresses

Primary practice location

15549 Ste Rte 170 Ste 1
Buckeye Pharmacy
East Liverpool, OH 43920

Mailing address

15549 Ste Rte 170 Ste 1
Buckeye Pharmacy
East Liverpool, OH 43920
Phone (330) 382-7726

Other identifiers 3

IdentifierTypeStateIssuer
02-1815800OtherOHOHIO STATE LICENSE
3810009042MedicaidWV
2813978MedicaidOH

Other names 1

  • Buckeye Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101207000701 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
Part of
Decaria Brothers Inc

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1356561427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15549 STE RTE 170 STE 1",
            "address_2": "BUCKEYE PHARMACY",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "43920",
            "telephone_number": "330-382-7726",
            "fax_number": "330-382-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15549 STE RTE 170 STE 1",
            "address_2": "BUCKEYE PHARMACY",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "43920",
            "telephone_number": "330-382-7726",
            "fax_number": "330-382-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECARIA BROTHERS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DECARIA BROTHERS INC.",
        "enumeration_date": "2007-04-30",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "DECARIA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHARMACIST- OWNER",
        "authorized_official_telephone_number": "330-382-7726"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "02-1815800",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-1815800",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OH",
            "license": "02-1815800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE LICENSE",
            "identifier": "02-1815800",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009042",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2813978",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckeye Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Liverpool, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.