Medwiz Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH30176 Issued in FL

Legal business name

MEDWIZ PHARMACY LLC

Practice address

240 N Main St
Spring Valley, NY 10977-4020

Phone

(845) 624-5200

Fax

(845) 624-5300

NPI assigned

Jul 28, 2017

Organization subpart

No

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

Authorized official

Name

Eric Newhouse

Title

Ceo

Phone

(845) 624-5200

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• MEDWIZ PHARMACY LLC Doing business as

Tax ID family

Medwiz Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medwiz Pharmacy LLC

  • Community/Retail Pharmacy
  • Spring Valley, NY
  • NPI 1477929529
  NPD tax ID

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501200000000",
    "number": "1093239337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N MAIN ST",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774020",
            "telephone_number": "845-624-5200",
            "fax_number": "845-624-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N MAIN ST",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774020",
            "telephone_number": "845-624-5200",
            "fax_number": "845-624-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWIZ PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A",
        "authorized_official_last_name": "NEWHOUSE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-624-5200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RO00140500",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH30176",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "029312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2170111",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04418659",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0548826",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDWIZ PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDWIZ PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Spring Valley, NY
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.