Active NPI
Howard Beach Apothecary Inc
- Community/Retail Pharmacy
- Howard Beach, NY
National Provider Identifier
1174520779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 018639
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey Liberman, R.PH.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00893792 | Medicaid | NY | |
| 2062354 | Other | PK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930053148 | NY | DME Supplier - Pharmacy | 9931229101 | Practice locations: Howard Beach, NY |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacist
- Howard Beach, NY
- NPI 1063424208
-
- Pharmacist
- Howard Beach, NY
- NPI 1134291461
-
- Pharmacist
- Howard Beach, NY
- NPI 1922011188
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.