Mge Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

011973 Issued in NY

Legal business name

MGE PHARMACY INC

Doing business as

DUTCH BROADWAY PHARMACY

Practice address

1785 Dutch Broadway
Elmont, NY 11003-5044

Phone

(516) 825-3177

Fax

(516) 825-1129

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Leonard Amoruso

Title

President Pharm

Phone

(516) 825-3177

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DUTCH BROADWAY PHARMACY Doing business as

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1063427680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 N HAWTHONE ST",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-825-3177",
            "fax_number": "516-825-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 DUTCH BROADWAY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035044",
            "telephone_number": "516-825-3177",
            "fax_number": "516-825-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "AMORUSO",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT PHARM",
        "authorized_official_telephone_number": "516-825-3177"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "011973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058276",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00263805",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUTCH BROADWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Elmont, NY
• Providers in Elmont, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.