Active NPI
Bartles Pharmacy Inc
- Durable Medical Equipment & Medical Supplies
- Oxford, NY
National Provider Identifier
1154400646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 24247
- Legal business name
- BARTLES PHARMACY INC
- Practice address
- 10 Lafayette Park
Oxford, NY 13830 - Phone
- (607) 843-2841
- Fax
- (607) 843-6874
- NPI assigned
- Nov 3, 2006
- 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. Brian W Bartle, PHARMACIST
- Title
- President Owner
- Phone
- (607) 843-2841
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 24247 | NY | Primary |
Addresses
Primary practice location
10 Lafayette Park
Oxford, NY 13830
Mailing address
10 Lafayette Park
PO Box 630
Oxford, NY 13830
Phone (607) 843-2841
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00451487 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090929000494 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981740271 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Oxford, NY |
| O20100930064106 | NY | DME Supplier - Pharmacy | 4981740271 | Practice locations: Oxford, NY |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205193600000",
"number": "1154400646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 LAFAYETTE PARK",
"address_2": "PO BOX 630",
"city": "OXFORD",
"state": "NY",
"postal_code": "13830",
"telephone_number": "607-843-2841",
"fax_number": "607-843-6874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 LAFAYETTE PARK",
"city": "OXFORD",
"state": "NY",
"postal_code": "13830",
"telephone_number": "607-843-2841",
"fax_number": "607-843-6874"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BARTLES PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-03",
"last_updated": "2008-03-11",
"status": "A",
"authorized_official_last_name": "BARTLE",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT OWNER",
"authorized_official_telephone_number": "607-843-2841",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NY",
"license": "24247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00451487",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.