Tim M Muccino

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP437667 Issued in PA

Practice address

2618- A Memorial BLD
Connellsville, PA 15425

Phone

(724) 628-7500

Fax

(724) 628-7550

NPI assigned

May 19, 2021

Last updated

May 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prescriptions Plus of Connellsville Inc

  dba Medmart Pharmacy

  • Community/Retail Pharmacy
  • Connellsville, PA
  • NPI 1497790612
  Authorized official Same address or phone

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1710551056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618- A MEMORIAL BLD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "15425",
            "telephone_number": "724-628-7500",
            "fax_number": "724-628-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618- A MEMORIAL BLD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "15425",
            "telephone_number": "724-628-7500",
            "fax_number": "724-628-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCINO",
        "first_name": "TIM",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP437667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016537570001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monongahela Valley Hospital, Inc. (Penn Highlands Mon Valley)
• Amanda Elisabeth Moore, PA-C
• Lindsay Moore, LCSW, CTP
• Jennifer Morgan
• Megan Jane Morris, PMHNP
• Lisa Marie Mumau, MED., NCC, LPC
• Candace Murin, MS, LBS
• Anvitha Nandella, PT, DPT
• Thomas A. Nelson III
• Neurodivergent Minds, LLC

• Pharmacist in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.