Active NPI
Livewell Pharmacy Inc
- Pharmacy
- Bronx, NY
National Provider Identifier
1154965317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- LIVEWELL PHARMACY INC
- Practice address
- 1432 E Gun Hill Rd
Bronx, NY 10469-3061 - Phone
- (347) 843-8562
- Fax
- (347) 843-8565
- NPI assigned
- Oct 31, 2019
- 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. Khalid M Chaudhary
- Title
- Pic
- Phone
- (347) 843-8562
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
1432 E Gun Hill Rd
Bronx, NY 10469-3061
Mailing address
1432 E Gun Hill Rd
Bronx, NY 10469-3061
Phone (347) 843-8562
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06077178 | Medicaid | NY |
Other names 1
- LIVEWELL PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210914003520 | NY | Part B Supplier - Pharmacy | 1951731512 | Practice locations: Bronx, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Brooklyn, NY
- NPI 1093238628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648684800000",
"number": "1154965317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1432 E GUN HILL RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104693061",
"telephone_number": "347-843-8562",
"fax_number": "347-843-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 E GUN HILL RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104693061",
"telephone_number": "347-843-8562",
"fax_number": "347-843-8565"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVEWELL PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-31",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"status": "A",
"authorized_official_last_name": "CHAUDHARY",
"authorized_official_first_name": "KHALID",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "347-843-8562",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06077178",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LIVEWELL PHARMACY",
"code": "5",
"type": "Other Name"
}
]
}
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 Mar 31, 2022; 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.