Organization Active NPI

Canalberry Corp.

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1104846492
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CANALBERRY CORP.
Practice address
82 Mulberry St FRNT B
New York, NY 10013-4450
Phone
(212) 619-6190
Fax
(212) 619-6191
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
Mr. Sunny Hung
Title
Secretary
Phone
(212) 619-6190

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 047089 NY
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

82 Mulberry St FRNT B
New York, NY 10013-4450

Mailing address

82 Mulberry St FRNT B
New York, NY 10013-4450
Phone (212) 619-6190

Other identifiers 1

IdentifierTypeStateIssuer
02602537MedicaidNY

Other names 1

  • CANALBERRY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930008224 NY DME Supplier - Pharmacy 0648480533 Practice locations: New York, NY
O20230925001699 NY Part B Supplier - Pharmacy 0648480533 Practice locations: New York, NY
O20240118001215 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0648480533 Practice locations: New York, 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
Canalberry Pharmacy82 Mulberry St, New York, NY 10013-4450(212) 619-6190 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Dec 9, 2023

National Provider Directory

National Provider Directory

Locations

82 Mulberry St
Frnt B
New York, NY 10013
Phone (212) 619-6190

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1104846492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 MULBERRY ST FRNT B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134450",
            "telephone_number": "212-619-6190",
            "fax_number": "212-619-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MULBERRY ST FRNT B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134450",
            "telephone_number": "212-619-6190",
            "fax_number": "212-619-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANALBERRY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "HUNG",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "212-619-6190",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047089",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02602537",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CANALBERRY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CANALBERRY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.