Five Towns Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00759500 Issued in NJ

Legal business name

FIVE TOWNS PHARMACY LLC

Doing business as

Invictus Pharmacy

Practice address

60 Essex St Ste 105
Rochelle Park, NJ 07662-4347

Phone

(201) 880-7000

Fax

(201) 880-7094

NPI assigned

Oct 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Meyer Davidoff, PHARMD, RPH

Title

Ceo

Phone

(201) 880-7000

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Invictus Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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.

• Meyer Davydov, PHARMD

  • Pharmacist
  • Rochelle Park, NJ
  • NPI 1063999829
  NPD
• Alan Alexander Oustaev, PHARM D.

  • Pharmacist
  • Rochelle Park, NJ
  • NPI 1477030997
  NPD
• Chhime Dokha Sherpa

  • Pharmacist
  • Rochelle Park, NJ
  • NPI 1407402068
  NPD (past)
• Michelle Tran, PHARMD

  • Pharmacist
  • Rochelle Park, NJ
  • NPI 1013758689
  NPD (past)

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1073024931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 ESSEX ST STE 105",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624347",
            "telephone_number": "201-880-7000",
            "fax_number": "201-880-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 ESSEX ST STE 105",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624347",
            "telephone_number": "201-880-7000",
            "fax_number": "201-880-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE TOWNS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "DAVIDOFF",
        "authorized_official_first_name": "MEYER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-880-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00759500",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2173100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "036775",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0605867",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Invictus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Invictus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Rochelle Park, NJ
• Providers in Rochelle Park, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.