Organization Active NPI

Livewell Pharmacy Inc

  • Pharmacy
  • Bronx, NY
National Provider Identifier
1154965317
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
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

Updated by the provider on Mar 31, 2022

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
06077178MedicaidNY

Other names 1

  • LIVEWELL PHARMACY Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210914003520 NY Part B Supplier - Pharmacy 1951731512 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "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.

Verify at the official NPI Registry.