NPIMap

Organization Active NPI

Drug Shoppe LLC

  • Long Term Care Pharmacy
  • New York, NY
National Provider Identifier
1043965031
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
DRUG SHOPPE LLC
Practice address
2074 Frederick Douglass Blvd
New York, NY 10026-3375
Phone
(212) 222-3652
NPI assigned
Feb 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Aniedi Nse Etuk, RPHNPI 1841522521
Title
President
Phone
(212) 222-3652

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
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

2074 Frederick Douglass Blvd
New York, NY 10026-3375

Mailing address

2074 Frederick Douglass Blvd
New York, NY 10026-3375

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Drug Shoppe LLC2074 Frederick Douglass Blvd, New York, NY 10026-3375(212) 222-3652 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Surgical Dressings Does not accept assignmentParticipating since Nov 13, 2003

National Provider Directory

National Provider Directory
Tax ID family
Drug Shoppe LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1043965031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263375",
            "telephone_number": "212-222-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRUG SHOPPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "ETUK",
        "authorized_official_first_name": "ANIEDI",
        "authorized_official_middle_name": "NSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-222-3652",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.