Organization Active NPI

Rutland Pharmacy LLC

Doing business as Rutland Pharmacy

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1043749724
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RUTLAND PHARMACY LLC
Doing business as
Rutland Pharmacy
Practice address
964 Rutland Rd
Brooklyn, NY 11212-1544
Phone
(718) 774-9613
Fax
(718) 774-9666
NPI assigned
Jun 7, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Narasimharao Nadendla, RPHNPI 1124397849
Title
Supervising Pharmacist
Phone
(718) 774-9613

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
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

964 Rutland Rd
Brooklyn, NY 11212-1544

Mailing address

964 Rutland Rd
Brooklyn, NY 11212-1544
Phone (718) 774-9613

Other names 1

  • RUTLAND PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120003840 NY DME Supplier - Pharmacy 9931466398 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

964 Rutland Rd
Brooklyn, NY 11212
Phone (718) 773-1058

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": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043749724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 RUTLAND RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121544",
            "telephone_number": "718-774-9613",
            "fax_number": "718-774-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 RUTLAND RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121544",
            "telephone_number": "718-774-9613",
            "fax_number": "718-774-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTLAND PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NADENDLA",
        "authorized_official_first_name": "NARASIMHARAO",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-774-9613",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RUTLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RUTLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.