Roosevelt Drug Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035080 Issued in NY

Legal business name

ROOSEVELT DRUG CORP

Doing business as

Roosevelt Drugs and Surgicals

Practice address

74 19 Roosevelt Ave
Jackson Heights, NY 11372-6529

Phone

(718) 424-1291

Fax

(718) 898-1860

NPI assigned

Aug 10, 2016

Last updated

Mar 31, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shujaat Mir

Title

President

Phone

(718) 424-1291

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Roosevelt Drugs and Surgicals Doing business as

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1134673965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 19 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726529",
            "telephone_number": "718-424-1291",
            "fax_number": "718-898-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 19 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726529",
            "telephone_number": "718-424-1291",
            "fax_number": "718-898-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT DRUG CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "MIR",
        "authorized_official_first_name": "SHUJAAT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-424-1291"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166657",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roosevelt Drugs and Surgicals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roosevelt Ave Pain Medicine PLLC
• Roosevelt Cardio Vascular Diagnostic, P.C.
• Roosevelt City Pharmacy Inc (City Pharmacy)
• Roosevelt Dental Care II P.C.
• Roosevelt Dental Care P.C.
• Roosevelt Optometry Associates PLLC (Roosevelt Family Eye Care)
• Roosevelt Women's Medical Care, PC
• Angie Rosado
• Grisel Rosado, RN
• Levy Rosado

• Community/Retail Pharmacy in Jackson Heights, NY
• Providers in Jackson Heights, 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 Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.