NPIMap

Organization Active NPI

CMV Pharmacy Inc

Doing business as Dougherty Pharmacy

  • Community/Retail Pharmacy
  • Canastota, NY
National Provider Identifier
1023884368
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CMV PHARMACY INC
Doing business as
Dougherty Pharmacy
Practice address
143 S Peterboro St
Canastota, NY 13032
Phone
(315) 875-7000
Fax
(315) 875-7979
NPI assigned
Nov 28, 2023
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Colin Valenta
Title
President
Phone
(607) 323-1303

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

143 S Peterboro St
Canastota, NY 13032

Mailing address

2 Westwood Dr
Johnson City, NY 13790-4318
Phone (607) 321-1562

Other names 1

  • Dougherty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120823000847 NY Part B Supplier - Pharmacy 5294982351 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Addison, NY; Canastota, NY; Cato, NY; Hamilton, NY; Morrisville, NY
O20240827003920 NY DME Supplier - Pharmacy 5294982351 Practice locations: Canastota, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
CMV Pharmacy Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1023884368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WESTWOOD DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137904318",
            "telephone_number": "607-321-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S PETERBORO ST",
            "city": "CANASTOTA",
            "state": "NY",
            "postal_code": "13032",
            "telephone_number": "315-875-7000",
            "fax_number": "315-875-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMV PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "VALENTA",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-323-1303"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dougherty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dougherty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canastota, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.