Active NPI
Kelly's Pharmacy Inc.
- Community/Retail Pharmacy
- Delmar, NY
National Provider Identifier
1073387957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- KELLY'S PHARMACY INC.
- Practice address
- 343 Delaware Ave
Delmar, NY 12054-1920 - Phone
- (518) 429-4085
- Fax
- (518) 429-4603
- NPI assigned
- Nov 10, 2023
- Last updated
- May 21, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Quinn Patrick Kelly, DR., RPH
- Title
- Owner/Pharmacist
- Phone
- (518) 429-4085
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
343 Delaware Ave
Delmar, NY 12054-1920
Mailing address
343 Delaware Ave
Delmar, NY 12054-1920
Phone (518) 429-4085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07833998 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190130001089 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 9739452566 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Delmar, NY; Greenville, NY; West Coxsackie, NY |
| O20240425003269 | NY | DME Supplier - Pharmacy | 9739452566 | Practice locations: Delmar, NY |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Kelly's Pharmacy Inc. | Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies | Does not accept assignment |
National Provider Directory
National Provider DirectoryLocations
343 Delaware Ave
Delmar, NY 12054
Phone (518) 429-4085
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Pharmacist
- Greenville, NY
- NPI 1952887895
-
- Pharmacist
- Delmar, NY
- NPI 1295643153
-
- Pharmacist
- Greenville, NY
- NPI 1801008156
-
- Pharmacist
- Greenville, NY
- NPI 1235644030
-
- Pharmacist
- Greenville, NY
- NPI 1740524891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747785600000",
"number": "1073387957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 DELAWARE AVE",
"city": "DELMAR",
"state": "NY",
"postal_code": "120541920",
"telephone_number": "518-429-4085",
"fax_number": "518-429-4603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "343 DELAWARE AVE",
"city": "DELMAR",
"state": "NY",
"postal_code": "120541920",
"telephone_number": "518-429-4085",
"fax_number": "518-429-4603"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLY'S PHARMACY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-10",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "QUINN",
"authorized_official_middle_name": "PATRICK",
"authorized_official_title_or_position": "OWNER/PHARMACIST",
"authorized_official_telephone_number": "518-429-4085",
"authorized_official_credential": "DR., RPH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07833998",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Delmar, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.