NPIMap

Organization Active NPI

State of New York

Doing business as Clinton Correctional Facility-Pharmacy

  • Institutional Pharmacy
  • Dannemora, NY
National Provider Identifier
1053713883
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
012999 Issued in NY
Legal business name
STATE OF NEW YORK
Doing business as
Clinton Correctional Facility-Pharmacy
Practice address
Cook St
Dannemora, NY 12929
Phone
(518) 492-2511
NPI assigned
Sep 24, 2014
Last updated
Jun 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Paulette Leduc, BACHELOR
Title
Pharmacy Supervisor
Phone
(518) 492-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 012999 NY Primary

Addresses

Primary practice location

Cook St
Dannemora, NY 12929

Mailing address

Cook St
PO Box 2000
Dannemora, NY 12929
Phone (518) 492-2511

Other identifiers 1

IdentifierTypeStateIssuer
2064781OtherPK

Other names 1

  • CLINTON CORRECTIONAL FACILITY-PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilton Devel Ctr Rev M269 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1053713883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COOK ST",
            "address_2": "PO BOX 2000",
            "city": "DANNEMORA",
            "state": "NY",
            "postal_code": "12929",
            "telephone_number": "518-492-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COOK ST",
            "city": "DANNEMORA",
            "state": "NY",
            "postal_code": "12929",
            "telephone_number": "518-492-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW YORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "LEDUC",
        "authorized_official_first_name": "PAULETTE",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "518-492-2511",
        "authorized_official_credential": "BACHELOR"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NY",
            "license": "012999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064781",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINTON CORRECTIONAL FACILITY-PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dannemora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.