NPIMap

Organization Active NPI

Omnicare of New York, LLC

  • Long Term Care Pharmacy
  • Charleston, SC
National Provider Identifier
1073699849
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
50-008477 Issued in SC
Legal business name
OMNICARE OF NEW YORK, LLC
Doing business as
Omnicare of Bishop Gadsden
Practice address
1 Bishop Gadsden Way
Charleston, SC 29412-3506
Phone
(843) 406-0902
Fax
(843) 406-0092
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Susan Colbert
Title
Sr Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 50-008477 SC
Long Term Care Pharmacy 3336L0003X 50-008477 SC Primary

Addresses

Primary practice location

1 Bishop Gadsden Way
Charleston, SC 29412-3506

Mailing address

201 E 4TH St
900 Omnicare Center
Cincinnati, OH 45202-4248
Phone (513) 719-2600

Other identifiers 1

IdentifierTypeStateIssuer
4224767OtherNCPDP

Other names 1

  • Omnicare of Bishop Gadsden Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150710001089 SC Part B Supplier - Mass Immunization (Roster Biller Only) 1355469891 1 other NPI on this enrollment
Practice locations: Charleston, SC

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1073699849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST",
            "address_2": "900 OMNICARE CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452024248",
            "telephone_number": "513-719-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BISHOP GADSDEN WAY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123506",
            "telephone_number": "843-406-0902",
            "fax_number": "843-406-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNICARE OF NEW YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "SC",
            "license": "50-008477",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "SC",
            "license": "50-008477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4224767",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omnicare of Bishop Gadsden",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.