Organization Active NPI

Lavida Pharmacy Inc.

  • Pharmacy
  • Elmhurst, NY
National Provider Identifier
1013978865
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
026192 Issued in NY
Legal business name
LAVIDA PHARMACY INC.
Practice address
4034 82ND St
Elmhurst, NY 11373-1305
Phone
(718) 426-2525
Fax
(718) 426-2523
NPI assigned
Mar 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Authorized official

Name
Ting Chen LeeNPI 1629246723
Title
Supervising Pharmacist
Phone
(718) 426-2525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 026192 NY Primary

Addresses

Primary practice location

4034 82ND St
Elmhurst, NY 11373-1305

Mailing address

4034 82ND St
Elmhurst, NY 11373-1305
Phone (718) 426-2525

Other identifiers 1

IdentifierTypeStateIssuer
02422879MedicaidNY

National Provider Directory

National Provider Directory

Locations

4034 82nd St
Elmhurst, NY 11373
Phone (718) 426-2525

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1013978865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-2525",
            "fax_number": "718-426-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4034 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-2525",
            "fax_number": "718-426-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVIDA PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TING CHEN",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-426-2525"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "026192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02422879",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.