Organization Active NPI

Rose Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1083780183
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
024640 Issued in NY
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

Updated by the provider on Dec 29, 2015

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02060057MedicaidNY
2060719OtherPK

Other names 1

  • ROSE PHARMACY INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 NPIMap

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

SupplierSuppliesMedicare assignment
Rose Pharmacy Inc1074A Liberty Ave, Brooklyn, NY 11208-2923(718) 235-3383 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 assignmentParticipating since Feb 6, 2012

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.