NPIMap

Individual provider Active NPI

Bruno A Decaria, RPH

  • Pharmacist
  • East Liverpool, OH
National Provider Identifier
1952404279
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-2-21105 Issued in OH
Practice address
104 E 5TH St
East Liverpool, OH 43920-3031
Phone
(330) 385-0825
Fax
(330) 385-8415
NPI assigned
Sep 6, 2006
Last updated
Apr 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03-2-21105 OH Primary
Pharmacist 183500000X RP0005753 WV

Addresses

Primary practice location

104 E 5TH St
East Liverpool, OH 43920-3031

Mailing address

104 E 5TH St
East Liverpool, OH 43920-3031
Phone (330) 385-0825

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP0005753WVMDPharmacist

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1952404279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 5TH 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 5TH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439203031",
            "telephone_number": "330-385-0825",
            "fax_number": "330-385-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARIA",
        "first_name": "BRUNO",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-2-21105",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0005753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 2, 2009; 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.