Organization Active NPI

STJ RX Inc.

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1104821370
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
017695 Issued in NY
Legal business name
STJ RX INC.
Practice address
720 Classon Ave
Brooklyn, NY 11238-4231
Phone
(718) 399-1800
Fax
(718) 399-2681
NPI assigned
Jun 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Authorized official

Name
Alex Perchuk, RPH
Title
Corporate Secretary
Phone
(718) 835-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 017695 NY Primary

Addresses

Primary practice location

720 Classon Ave
Brooklyn, NY 11238-4231

Mailing address

720 Classon Ave
Brooklyn, NY 11238-4231
Phone (718) 399-1800

Other identifiers 1

IdentifierTypeStateIssuer
01016068MedicaidNY

Other names 1

  • Thriftway Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930091366 NY DME Supplier - Pharmacy 5799808770 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
STJ RX Inc720 Classon Ave, Brooklyn, NY 11238-4231(718) 399-1800 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchair Seating/Cushions|Neurostimulators and/or Supplies|Ostomy Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Nov 28, 2000

National Provider Directory

National Provider Directory

Locations

720 Classon Ave
Brooklyn, NY 11238
Phone (718) 399-1800

Practitioners & affiliated clinicians

Practitioners 2

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": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1104821370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 CLASSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384231",
            "telephone_number": "718-399-1800",
            "fax_number": "718-399-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 CLASSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384231",
            "telephone_number": "718-399-1800",
            "fax_number": "718-399-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STJ RX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "PERCHUK",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "718-835-2000",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "017695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01016068",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thriftway Pharmacy",
            "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 Jul 19, 2013; 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.