Organization Active NPI

Melrose Ave Pharmacy LLC

  • Community/Retail Pharmacy
  • Bronx, NY
National Provider Identifier
1164134656
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MELROSE AVE PHARMACY LLC
Practice address
899 Melrose Ave
Bronx, NY 10451-4166
Phone
(917) 915-5656
Fax
(718) 292-4583
NPI assigned
Dec 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Pujitha Reddy Nalanagula
Title
Member
Phone
(917) 915-5656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

899 Melrose Ave
Bronx, NY 10451-4166

Mailing address

899 Melrose Ave
Bronx, NY 10451-4166
Phone (917) 915-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230306000964 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1456724814 Practice locations: Bronx, NY
O20230619000048 NY DME Supplier - Pharmacy 1456724814 Practice locations: Bronx, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Melrose Ave Pharmacy LLC899 Melrose Ave, Bronx, NY 10451-4166(917) 915-5656 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 10, 2023

National Provider Directory

National Provider Directory

Locations

899 Melrose Ave
Bronx, NY 10451
Phone (917) 915-5656

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1164134656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 MELROSE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514166",
            "telephone_number": "917-915-5656",
            "fax_number": "718-292-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 MELROSE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514166",
            "telephone_number": "917-915-5656",
            "fax_number": "718-292-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSE AVE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "NALANAGULA",
        "authorized_official_first_name": "PUJITHA REDDY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-915-5656"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.