NPIMap

Organization Active NPI

Martin Drugs of Riverhead,Inc

  • Pharmacy
  • Riverhead, NY
National Provider Identifier
1053308684
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
019246 Issued in NY
Legal business name
MARTIN DRUGS OF RIVERHEAD,INC
Practice address
849 Old Country Rd
Riverhead, NY 11901-2106
Phone
(631) 727-0550
Fax
(631) 727-3054
NPI assigned
Sep 29, 2005
Last updated
Apr 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Mr. Rajendraprasad Venigalla, RPHNPI 1942457049
Title
Owner Pres
Phone
(347) 528-8893

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 019246 NY Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

849 Old Country Rd
Riverhead, NY 11901-2106

Mailing address

849 Old Country Rd
Riverhead, NY 11901-2106
Phone (631) 727-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930072789 NY DME Supplier - Pharmacy 0648475251 Practice locations: Riverhead, NY
O20210128001413 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0648475251 Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory
Tax ID family
Martin Drugs of Riverheadinc2 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 4

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1053308684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012106",
            "telephone_number": "631-727-0550",
            "fax_number": "631-727-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012106",
            "telephone_number": "631-727-0550",
            "fax_number": "631-727-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN DRUGS OF RIVERHEAD,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "VENIGALLA",
        "authorized_official_first_name": "RAJENDRAPRASAD",
        "authorized_official_title_or_position": "OWNER PRES",
        "authorized_official_telephone_number": "347-528-8893",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "019246",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.