Organization Active NPI

Asm Pharmacy Corp

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1104923044
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
025510 Issued in NY
Legal business name
ASM PHARMACY CORP
Practice address
1604 Avenue M
Brooklyn, NY 11230-6007
Phone
(718) 375-8900
Fax
(718) 375-0478
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Mikhail Roymtan
Title
Manager/Owner
Phone
(718) 375-8900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 025510 NY Primary

Addresses

Primary practice location

1604 Avenue M
Brooklyn, NY 11230-6007

Mailing address

1604 Avenue M
Brooklyn, NY 11230-6007
Phone (718) 375-8900

Other identifiers 2

IdentifierTypeStateIssuer
3328019OtherNCPDP PROVIDER IDENTIFICATION NUMBER
02339673MedicaidNY

Other names 1

  • GOOD NEIGHBOR PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930054540 NY DME Supplier - Pharmacy 0547475923 Practice locations: Brooklyn, NY
O20210430001110 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0547475923 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Asm Pharmacy Corp2 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.

Locations

1604 Avenue M
Brooklyn, NY 11230
Phone (718) 375-8900

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1104923044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306007",
            "telephone_number": "718-375-8900",
            "fax_number": "718-375-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306007",
            "telephone_number": "718-375-8900",
            "fax_number": "718-375-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASM PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "ROYMTAN",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "718-375-8900"
    },
    "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": "025510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3328019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02339673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOOD NEIGHBOR 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 Nov 25, 2024; 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.