Four Corners Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027103 Issued in NY

Legal business name

FOUR CORNERS PHARMACY LLC

Doing business as

Four Corners Pharmacy

Practice address

360 Delaware Ave
Delmar, NY 12054-1904

Phone

(518) 439-8200

Fax

(518) 439-3657

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

John L Croce, RPHNPI 1912015611

Title

Co-Owner

Phone

(518) 439-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Four Corners Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John L Croce, RPH

  • Pharmacist
  • Delmar, NY
  • NPI 1912015611
  NPD (past) Authorized official

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1083722771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541904",
            "telephone_number": "518-439-8200",
            "fax_number": "518-439-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541904",
            "telephone_number": "518-439-8200",
            "fax_number": "518-439-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "CROCE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "518-439-8200",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02634426",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Corners Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Flood, PHARM D
• Shannon Foglia
• Sandra Foley
• Forefront Medical Services, PLLC (Delmar Family Medicine)
• Michelle Marci Foster, LCSW
• Myrna L Friedlander, PHD
• Roy Fruiterman
• Jacqueline A Gaffney, LCSW-R
• Susan Gardiner, M.D.
• Nancy Noble Gardner, LCSW

• Community/Retail Pharmacy in Delmar, NY
• Providers in Delmar, 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 Aug 6, 2013; 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.