Vicram Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030129 Issued in NY

Legal business name

VICRAM PHARMACY INC

Practice address

2244 Church Ave
Brooklyn, NY 11226-4195

Phone

(718) 941-7722

Fax

(718) 941-0023

NPI assigned

Mar 26, 2010

Organization subpart

No

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

Authorized official

Name

Balaji Duddukuru

Title

President

Phone

(718) 941-7722

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ROYAL PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1114241692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263201",
            "telephone_number": "718-941-7722",
            "fax_number": "718-941-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264195",
            "telephone_number": "718-941-7722",
            "fax_number": "718-941-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICRAM PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "DUDDUKURU",
        "authorized_official_first_name": "BALAJI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-941-7722"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5801142",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03235132",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROYAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROYAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Marie Vick, R-DMT
• Asiya Vickers
• Daynesha Vicks
• Vicky Mesrie Psychology, PLLC
• Vicky Mesrie, LLC
• Victor J Masi DO PC
• Devorah Victor Reisan
• Daryl Jay Victor, M.D.
• Fabienne Victor, LPN
• Jacqueline Victor

• 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 5, 2021; 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.