NPIMap

Organization Active NPI

Boulevard Pharmacy Corp

  • Community/Retail Pharmacy
  • Garden City, NY
National Provider Identifier
1033309547
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
028612 Issued in NY
Legal business name
BOULEVARD PHARMACY CORP
Practice address
10 Nassau Blvd So
Garden City, NY 11530
Phone
(516) 505-7979
Fax
(516) 505-7981
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Pasquale MinutoNPI 1518138619
Title
President
Phone
(516) 505-7979

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 028612 NY Primary

Addresses

Primary practice location

10 Nassau Blvd So
Garden City, NY 11530

Mailing address

10 Nassau Blvd So
Garden City, NY 11530
Phone (516) 505-7979

Other identifiers 2

IdentifierTypeStateIssuer
3355737OtherNCPDP PROVIDER IDENTIFICATION NUMBER
03069647MedicaidNY

Other names 1

  • GARDEN CITY FAMILY PHARMACY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1033309547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NASSAU BLVD SO",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-505-7979",
            "fax_number": "516-505-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NASSAU BLVD SO",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-505-7979",
            "fax_number": "516-505-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "MINUTO",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-505-7979"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3355737",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03069647",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARDEN CITY FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.