Organization Active NPI

Howard Beach Apothecary Inc

  • Community/Retail Pharmacy
  • Howard Beach, NY
National Provider Identifier
1174520779
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
018639 Issued in NY
Legal business name
HOWARD BEACH APOTHECARY INC
Practice address
158-40 Cross Bay Blvd
Howard Beach, NY 11414-3136
Phone
(718) 738-4343
Fax
(718) 845-1420
NPI assigned
Jun 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Authorized official

Name
Jeffrey Liberman, R.PH.NPI 1063424208
Title
Owner and Sup Pharmacist
Phone
(718) 738-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 018639 NY Primary

Addresses

Primary practice location

158-40 Cross Bay Blvd
Howard Beach, NY 11414-3136

Mailing address

158-40 Cross Bay Blvd
Howard Beach, NY 11414-3136
Phone (718) 738-4343

Other identifiers 2

IdentifierTypeStateIssuer
00893792MedicaidNY
2062354OtherPK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930053148 NY DME Supplier - Pharmacy 9931229101 Practice locations: Howard Beach, NY

National Provider Directory

National Provider Directory

Locations

15840 Crossbay Blvd
Howard Beach, NY 11414
Phone (718) 738-4343

Practitioners & affiliated clinicians

Practitioners 3

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": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1174520779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158-40 CROSS BAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143136",
            "telephone_number": "718-738-4343",
            "fax_number": "718-845-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158-40 CROSS BAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143136",
            "telephone_number": "718-738-4343",
            "fax_number": "718-845-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD BEACH APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "LIBERMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER AND SUP PHARMACIST",
        "authorized_official_telephone_number": "718-738-4343",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "018639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00893792",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2062354",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.