Gramatan Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

023264 Issued in NY

Legal business name

GRAMATAN PHARMACY CORP

Doing business as

Circle RX

Practice address

120 Gramatan Ave
Mount Vernon, NY 10550-1206

Phone

(914) 665-5555

Fax

(914) 665-5562

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Mark Rauchwerger

Title

Owner/Pharmacist

Phone

(914) 665-5555

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CIRCLE RX Doing business as

Locations

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1033213095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105501206",
            "telephone_number": "914-665-5555",
            "fax_number": "914-665-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105501206",
            "telephone_number": "914-665-5555",
            "fax_number": "914-665-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAMATAN PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "RAUCHWERGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "914-665-5555"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "023264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066769",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01713262",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIRCLE RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lemar Anthony Gordon, LPN
• Randall Gordon Jr.
• Kiana Goshorn
• Monique Graham, RN
• Gramatan Health Supplies LLC
• Michele Grant
• Teresa Grant, LMSW
• Daryl Wesley Graves, MD
• Nicodee Simone Gray-Brooks
• Dorett Gray-Harris

• Community/Retail Pharmacy in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Community/Retail Pharmacy in New York

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