Pharmakon Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022765 Issued in NY

Legal business name

PHARMAKON PHARMACY INC

Practice address

1914 Avenue M
Brooklyn, NY 11230-6202

Phone

(718) 375-2400

Fax

(718) 375-3805

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Edward Glazarov, RPHNPI 1538482005

Title

Pres.

Phone

(718) 375-2400

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NOTTINGHAM PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Glazarov

  • Pharmacist
  • Brooklyn, NY
  • NPI 1538482005
  NPD Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1104923036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306361",
            "telephone_number": "718-375-2400",
            "fax_number": "718-375-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306202",
            "telephone_number": "718-375-2400",
            "fax_number": "718-375-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMAKON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "GLAZAROV",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "718-375-2400",
        "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": "022765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01610360",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058487",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOTTINGHAM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NOTTINGHAM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.