Individual provider Active NPI

Fred Sanders, R.PH.

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1104008739
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
033538 Issued in NY
Practice address
1650 Grand Concourse
Duane Reade
Bronx, NY 10457-7606
Phone
(718) 716-3143
Fax
(718) 716-3568
NPI assigned
Dec 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 033538 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Duane Reade
Bronx, NY 10457-7606

Mailing address

1650 Grand Concourse
Duane Reade
Bronx, NY 10457-7606
Phone (718) 716-3143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1104008739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "DUANE READE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-716-3143",
            "fax_number": "718-716-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "DUANE READE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-716-3143",
            "fax_number": "718-716-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "FRED",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "033538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.