NPIMap

Organization Active NPI

Decaria Brothers, Inc

Doing business as Herche-Bloor Pharmacy

  • Pharmacy
  • East Liverpool, OH
National Provider Identifier
1588652135
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
020178800 Issued in OH
Legal business name
DECARIA BROTHERS, INC
Doing business as
Herche-Bloor Pharmacy
Practice address
104 E Fifth St
East Liverpool, OH 43920-3031
Phone
(330) 385-0825
Fax
(330) 385-8415
NPI assigned
Oct 7, 2005
Last updated
Jan 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Mr. Bruno Decaria, RPHNPI 1952404279
Title
Pharmacist/ Owner
Phone
(330) 385-0825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 020178800 OH Primary

Addresses

Primary practice location

104 E Fifth St
East Liverpool, OH 43920-3031

Mailing address

104 E Fifth St
East Liverpool, OH 43920-3031
Phone (330) 385-0825

Other identifiers 3

IdentifierTypeStateIssuer
3621631OtherNABP
0475936MedicaidOH
0143494000MedicaidWV

Other names 1

  • Herche-Bloor Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050718000880 OH Part B Supplier - Mass Immunization (Roster Biller Only) 8426085861 Practice locations: East Liverpool, OH
O20100930083772 OH DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 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
Herche Bloor Pharmacy12 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
East Liverpool, OH 43920
Phone (330) 385-0825

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1421712000000",
    "number": "1588652135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E FIFTH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439203031",
            "telephone_number": "330-385-0825",
            "fax_number": "330-385-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E FIFTH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439203031",
            "telephone_number": "330-385-0825",
            "fax_number": "330-385-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECARIA BROTHERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "DECARIA",
        "authorized_official_first_name": "BRUNO",
        "authorized_official_title_or_position": "PHARMACIST/ OWNER",
        "authorized_official_telephone_number": "330-385-0825",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "020178800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3621631",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0475936",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143494000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herche-Bloor 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 Jan 20, 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.

Verify at the official NPI Registry.