Active NPI
Rose Pharmacy Inc
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1083780183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 024640
- Legal business name
- ROSE PHARMACY INC
- Doing business as
- ROSE PHARMACY INC
- Practice address
- 1074A Liberty Ave
Brooklyn, NY 11208-2923 - Phone
- (718) 235-3383
- Fax
- (718) 235-3381
- NPI assigned
- Nov 28, 2006
- 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
- Ajay Maganti, RPH
- Title
- Supervising Phcst
- Phone
- (718) 235-3383
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 024640 | NY | Primary |
Addresses
Primary practice location
1074A Liberty Ave
Brooklyn, NY 11208-2923
Mailing address
1074A Liberty Ave
Brooklyn, NY 11208-2923
Phone (718) 235-3383
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02060057 | Medicaid | NY | |
| 2060719 | Other | PK |
Other names 1
- ROSE PHARMACY INC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120419000537 | NY | DME Supplier - Pharmacy | 6305007238 | Practice locations: Brooklyn, NY |
| O20230221000713 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 6305007238 | Practice locations: Brooklyn, NY |
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 |
|---|---|---|
| Rose Pharmacy Inc | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Infrared Heating Pads Systems and/or Supplies|… | Does not accept assignment |
National Provider Directory
National Provider DirectoryLocations
1074A Liberty Ave
Brooklyn, NY 11208
Phone (718) 235-3383
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Brooklyn, NY
- NPI 1700178845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1451347200000",
"number": "1083780183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1074A LIBERTY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112082923",
"telephone_number": "718-235-3383",
"fax_number": "718-235-3381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1074A LIBERTY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112082923",
"telephone_number": "718-235-3383",
"fax_number": "718-235-3381"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2015-12-29",
"status": "A",
"authorized_official_last_name": "MAGANTI",
"authorized_official_first_name": "AJAY",
"authorized_official_title_or_position": "SUPERVISING PHCST",
"authorized_official_telephone_number": "718-235-3383",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "024640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02060057",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2060719",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ROSE PHARMACY INC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.