Individual provider Active NPI

Anthony Fossaceca, PHARMD

  • Pharmacist
  • Alliance, OH
National Provider Identifier
1912422338
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03334547 Issued in OH
Practice address
1895 West State Street
Alliance, OH 44601
Phone
(330) 823-0850
NPI assigned
Aug 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03334547 OH Primary

Addresses

Primary practice location

1895 West State Street
Alliance, OH 44601

Mailing address

1895 West State Street
Alliance, OH 44601
Phone (330) 823-0850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03334547OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Father & Son Pharmaceuticals, LLC Past Accepting new patients
Lane Drug Co PastSince May 3, 2020 Accepting new patients
Lane Drug Co PastSince May 3, 2020 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1912422338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 WEST STATE STREET",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "44601",
            "telephone_number": "330-823-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 WEST STATE STREET",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "44601",
            "telephone_number": "330-823-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSACECA",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03334547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.