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DEPIETROS PHARMACY LLC
NPI 1720358344
Pharmacy - Community/Retail Pharmacy in Dunmore, PA

Active since January 12, 2012CLIA 39D2210789 · Waiver
617 3RD ST, DUNMORE, PA 18512(570) 209-7440(570) 209-7442 Get Directions Write a Review

NPPES record last updated: October 30, 2012. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Depietros Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEPIETROS PHARMACY LLC (NPI 1720358344) is a healthcare organization registered as a community/retail pharmacy in Dunmore, Pennsylvania and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through January 22, 2027 and lists Thomas Depietro, Pharmacy Manager/owner, as its authorized official.

NPPES Registry Identity

NPI1720358344
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameDEPIETROS PHARMACY LLC
Location Address617 3RD STDunmore, PA 18512-2849
Mailing Address617 3rd StDunmore, PA 18512-2849 · (570) 209-7440 · Fax (570) 209-7442
Phone(570) 209-7440
Fax(570) 209-7442
Organization SubpartNo
Authorized OfficialThomas DepietroPharmacy Manager/owner · (570) 209-7440
Enumeration DateJanuary 12, 2012
Last NPPES UpdateOctober 30, 2012
✔ NPI 1720358344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in PA · PP482235
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
617 3RD ST, Dunmore, PA 18512
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Other Names 1

Doing Business AsDepietros Pharmacy Llc

Other Identifiers 2

Medicare NSC6709490001
Other3996646Ncpdp Provider Identification Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Depietros Pharmacy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20120306000642Non-DME Part B · PharmacyDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2210789

Depietro's Pharmacy · Dunmore, PA
Active · expires Jan 22, 2027
CLIA Number39D2210789
Laboratory TypePharmacy
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorThomas R. Depietro
Laboratory Phone(570) 209-7440
Laboratory LocationDepietro's Pharmacy617 3rd Street, Dunmore, PA 18512
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
730 services726 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
685 services685 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
59 services59 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
59 services59 patients

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADRIANNA NEE PHARMD
Pharmacist
617 3RD ST
DUNMORE, PA 18512
Lackawanna County (570) 209-7440
DANE ROBERT CRAIG
Pharmacist
617 3RD ST
DUNMORE, PA 18512
Lackawanna County (570) 209-7440
JOSEPH JOHN GAUGHAN III
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
617 3RD ST
DUNMORE, PA 18512
Lackawanna County (570) 209-7440
DEPIETROS PHARMACY LLC
Pharmacy (Long Term Care Pharmacy)
617 3RD ST
DUNMORE, PA 18512
Lackawanna County (570) 209-7440

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Depietros Pharmacy LLC's NPI number?

The NPI number for Depietros Pharmacy LLC is 1720358344. It was assigned to this organization in the NPPES registry on January 12, 2012.

Where is Depietros Pharmacy LLC located?

Depietros Pharmacy LLC is located at 617 3rd St, Dunmore, PA 18512. The listed phone number is (570) 209-7440.

What is Depietros Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Depietros Pharmacy LLC enrolled in Medicare?

Yes. Depietros Pharmacy LLC is registered in the Medicare PECOS enrollment system.

When is Depietros Pharmacy LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Pharmacy) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Depietros Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2210789) is associated with this NPI, valid through January 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Depietros Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and Ambetter from Buckeye Health Plan and 41 other insurers list Depietros Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Depietros Pharmacy LLC was last updated on October 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.