Organization Active NPI

Mile Square Pharmacy Inc

  • Community/Retail Pharmacy
  • Yonkers, NY
National Provider Identifier
1003968652
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
013593 Issued in NY
Legal business name
MILE SQUARE PHARMACY INC
Practice address
855 Midland Ave
Yonkers, NY 10704-1024
Phone
(914) 965-1878
Fax
(914) 963-4022
NPI assigned
Jan 16, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Robert Lepore
Title
President Supervising Pharmacist
Phone
(914) 965-1878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 013593 NY Primary

Addresses

Primary practice location

855 Midland Ave
Yonkers, NY 10704-1024

Mailing address

855 Midland Ave
Yonkers, NY 10704-1024
Phone (914) 965-1878

Other identifiers 2

IdentifierTypeStateIssuer
013593OtherNYSTATE LICENSE
00570021MedicaidNY

National Provider Directory

National Provider Directory

Locations

855 Midland Ave
Yonkers, NY 10704
Phone (914) 965-1878

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1003968652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MIDLAND AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107041024",
            "telephone_number": "914-965-1878",
            "fax_number": "914-963-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MIDLAND AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107041024",
            "telephone_number": "914-965-1878",
            "fax_number": "914-963-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE SQUARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LEPORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "914-965-1878",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "013593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "013593",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00570021",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.