Legacy Drugstore Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00703600 Issued in NJ

Legal business name

LEGACY DRUGSTORE INC

Doing business as

Legacy Drugstore

Practice address

400 S Broad St
Elizabeth, NJ 07202-3502

Phone

(908) 352-0050

Fax

(908) 352-0075

NPI assigned

May 28, 2010

Last updated

Feb 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gurdine SomaNPI 1497078596

Title

Pharmacist, Owner

Phone

(908) 352-0050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legacy Drugstore Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gurdine Soma, B.S

  • Pharmacist
  • Farmingdale, NJ
  • NPI 1497078596
  NPD Authorized official
• Bindu Abraham

  • Pharmacist
  • Elizabeth, NJ
  • NPI 1093444788
  NPD (past)
• Meenakshi Vadrevu

  • Pharmacist
  • New York, NY
  • NPI 1619394459
  NPD (past)

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1003135195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023502",
            "telephone_number": "908-352-0050",
            "fax_number": "908-352-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023502",
            "telephone_number": "908-352-0050",
            "fax_number": "908-352-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DRUGSTORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "SOMA",
        "authorized_official_first_name": "GURDINE",
        "authorized_official_title_or_position": "PHARMACIST, OWNER",
        "authorized_official_telephone_number": "908-352-0050"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00703600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Drugstore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Lee, LCSW
• Han Sheng Lee
• Jay Lee, D.D.S.
• Nan-Yi Michael Lee, DDS
• Sangbeen Lee
• Sari Lehrhoff, M.D.
• Mark Leja, APN
• Mariela Lemes Aleman, RPH
• Agnieszka Lesniak, APN
• Matthew Letizia

• Community/Retail Pharmacy in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.