Elmira Correctional Facility

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

Legal business name

ELMIRA CORRECTIONAL FACILITY

Practice address

1879 Davis St # 500
Elmira, NY 14901-1042

Phone

(607) 734-3901

NPI assigned

Sep 17, 2021

Last updated

Sep 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derik WandellNPI 1538519228

Title

Supervising Pharmacist

Phone

(607) 734-3901

Specialties & licenses 1

Addresses

Locations

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.

• Derik Wandell

  • Pharmacist
  • Elmira, NY
  • NPI 1538519228
  NPD Authorized official

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1053081364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 DAVIS ST # 500",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 DAVIS ST # 500",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011042",
            "telephone_number": "607-734-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMIRA CORRECTIONAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "WANDELL",
        "authorized_official_first_name": "DERIK",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "607-734-3901"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia P Ellis
• Elmira ASC LLC
• Elmira City School District
• Elmira City School District
• Elmira College
• Elmira Family Dentistry P.L.L.C.
• Elmira Hearing Aid Center
• Elmira Medical Urgent Care PLLC
• Elmira PC
• Elmira Psychiatric Center

• Institutional Pharmacy in Elmira, NY
• Providers in Elmira, NY by specialty
• Institutional Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.