Organization Active NPI

Marras Pharmacy Inc

  • Durable Medical Equipment & Medical Supplies
  • Cohoes, NY
National Provider Identifier
1063496404
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
007907 Issued in NY
Legal business name
MARRAS PHARMACY INC
Practice address
217 Remsen St
Cohoes, NY 12047-3024
Phone
(518) 237-2110
Fax
(518) 237-5533
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Authorized official

Name
Mr. John T McDonald III, RPH
Title
President
Phone
(518) 237-2110

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 007907 NY Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

217 Remsen St
Cohoes, NY 12047-3024

Mailing address

217 Remsen St
PO Box 229
Cohoes, NY 12047-3024
Phone (518) 237-2110

Other identifiers 4

IdentifierTypeStateIssuer
10005286OtherNYCDPHP
007907OtherNYSTATE PHARMACY LICENSE
000400474001OtherNYBLUE SHIELD
00516207MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120821000011 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1153448592 Practice locations: Cohoes, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1063496404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 REMSEN ST",
            "address_2": "PO BOX 229",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120473024",
            "telephone_number": "518-237-2110",
            "fax_number": "518-237-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 REMSEN ST",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120473024",
            "telephone_number": "518-237-2110",
            "fax_number": "518-237-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARRAS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-237-2110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "007907",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10005286",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "007907",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000400474001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00516207",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohoes, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.