Organization Active NPI

Morris Park Pharmacy Inc

  • Community/Retail Pharmacy
  • Bronx, NY
National Provider Identifier
1114551256
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MORRIS PARK PHARMACY INC
Practice address
1160 E Tremont Ave
Bronx, NY 10460-2452
Phone
(631) 458-7258
Fax
(631) 458-7259
NPI assigned
Feb 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Yahia A Aldailam
Title
President
Phone
(631) 458-7258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1160 E Tremont Ave
Bronx, NY 10460-2452

Mailing address

1160 E Tremont Ave
Bronx, NY 10460-2452
Phone (631) 458-7258

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200528000771 NY DME Supplier - Pharmacy 7315368438 Practice locations: Bronx, NY
O20231004002360 NY Part B Supplier - Pharmacy 7315368438 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Tax ID family
Morris Park Pharmacy Inc2 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

1160 E Tremont Ave
Bronx, NY 10460
Phone (631) 458-7258

Practitioners & affiliated clinicians

Practitioners 4

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": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1114551256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602452",
            "telephone_number": "631-458-7258",
            "fax_number": "631-458-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602452",
            "telephone_number": "631-458-7258",
            "fax_number": "631-458-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRIS PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "ALDAILAM",
        "authorized_official_first_name": "YAHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-458-7258"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.