Active NPI
1325 Fifth Ave Drugs Inc
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1124573175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 034982
- Legal business name
- 1325 FIFTH AVE DRUGS INC
- Practice address
- 3206 Mermaid Ave
Brooklyn, NY 11224-1810 - Phone
- (718) 996-4949
- Fax
- (718) 996-3676
- NPI assigned
- Aug 19, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Muhammad Siddique
- Title
- President
- Phone
- (718) 996-4949
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 034982 | NY | Primary |
Addresses
Primary practice location
3206 Mermaid Ave
Brooklyn, NY 11224-1810
Mailing address
3206 Mermaid Ave
Brooklyn, NY 11224-1810
Phone (718) 996-4949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2166548 | Other | PK |
Other names 1
- Oceanside Pharmacy & Supermarket
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170522002243 | NY | DME Supplier - Pharmacy | 5193092252 | Practice locations: Brooklyn, NY |
| O20230413000372 | NY | Part B Supplier - Pharmacy | 5193092252 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider Directory- Tax ID family
- 1325 Fifth Ave Drugs Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Brooklyn, NY
- NPI 1093573719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471564800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698796800000",
"number": "1124573175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3206 MERMAID AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112241810",
"telephone_number": "718-996-4949",
"fax_number": "718-996-3676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3206 MERMAID AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112241810",
"telephone_number": "718-996-4949",
"fax_number": "718-996-3676"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "1325 FIFTH AVE DRUGS INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-19",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A",
"authorized_official_last_name": "SIDDIQUE",
"authorized_official_first_name": "MUHAMMAD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-996-4949",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "034982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2166548",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Oceanside Pharmacy & Supermarket",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Oceanside Pharmacy & Supermarket",
"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 1, 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.