NPIMap

Organization Active NPI

Avalon Gardens Rehabilitation & Health Care Ctr LLC

  • Long Term Care Pharmacy
  • Smithtown, NY
National Provider Identifier
1003920992
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
026282 Issued in NY
Legal business name
AVALON GARDENS REHABILITATION & HEALTH CARE CTR LLC
Practice address
7 Route 25a
Smithtown, NY 11787-1626
Phone
(631) 724-2200
Fax
(631) 724-2909
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Susan Oconnor, LNHA
Title
Administrator
Phone
(631) 724-2200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X 026282 NY Primary

Addresses

Primary practice location

7 Route 25a
Smithtown, NY 11787-1626

Mailing address

7 Route 25a
Smithtown, NY 11787-1626
Phone (631) 724-2200

Other identifiers 2

IdentifierTypeStateIssuer
2063005OtherPK
02569895MedicaidNY

Other names 1

  • AVALON GARDENS REHABILITATION AND HEALTH CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avalon Gardens Rehabilitation and Health Care Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7 Route 25A
Smithtown, NY 11787
Phone (516) 922-1056

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1003920992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-724-2200",
            "fax_number": "631-724-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-724-2200",
            "fax_number": "631-724-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON GARDENS REHABILITATION & HEALTH CARE CTR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-724-2200",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "026282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02569895",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVALON GARDENS REHABILITATION AND HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.