Costa Drugs Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PP410982L Issued in PA

Legal business name

COSTA DRUGS INC

Practice address

100 Old Lackawanna TRL
Clarks Summit, PA 18411-9108

Phone

(570) 587-4717

Fax

(570) 587-2619

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack L Cellerari, RPHNPI 1942368592

Title

Manager

Phone

(570) 587-4717

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 2

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

• Jack L Cellerari, R.PH.

  • Pharmacist
  • Clarks Summit, PA
  • NPI 1942368592
  NPD (past) Authorized official
• Joseph J Costa, RPH

  • Pharmacist
  • Dickson City, PA
  • NPI 1114099777
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1891867966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD LACKAWANNA TRL",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119108",
            "telephone_number": "570-587-4717",
            "fax_number": "570-587-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OLD LACKAWANNA TRL",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119108",
            "telephone_number": "570-587-4717",
            "fax_number": "570-587-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTA DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CELLERARI",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "570-587-4717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP410982L",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410982L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "3938721",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005826490002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACE PROVIDER NUMBER",
            "identifier": "0393872",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CNB Therapy Counseling Services, LLC
• Jose Collado
• Dale W Collins, D.D.S.
• Community Life Support Systems, Inc.
• Katherine Connors
• Natasha Coy, PSYD
• Kayla Cross
• Judy Cutler, PT
• Sandra Ann Dana, CRNP
• Eric John Darling

• All providers in Clarks Summit, PA
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.