Active NPI
Genovese Drug Stores Inc
- Community/Retail Pharmacy
- Danbury, CT
National Provider Identifier
1174622492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 1883
- Legal business name
- GENOVESE DRUG STORES INC
- Practice address
- 113 115 Mill Plain Road
Danbury, CT 06811-5277 - Phone
- (203) 798-7520
- NPI assigned
- Sep 22, 2006
- 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
- Jennifer M Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 1883 | CT | Primary |
Addresses
Primary practice location
113 115 Mill Plain Road
Danbury, CT 06811-5277
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004228567 | Medicaid | CT | |
| 004231239 | Other | CT | MEDICAID DME |
| 0719382 | Other | NCPDP |
Other names 1
- RITE AID PHARMACY 10384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090430000001 | CT | Part B Supplier - Mass Immunization (Roster Biller Only) | 5597832675 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Brookfield, CT; Ridgefield, CT |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
113 Mill Plain Rd
Danbury, CT 06811
Phone (203) 798-7520
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Danbury, CT
- NPI 1467740449
-
- Pharmacist
- Danbury, CT
- NPI 1669751285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331683200000",
"number": "1174622492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NEWBERRY COMMONS",
"city": "ETTERS",
"state": "PA",
"postal_code": "173199363",
"telephone_number": "717-761-2633",
"fax_number": "717-975-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 115 MILL PLAIN ROAD",
"city": "DANBURY",
"state": "CT",
"postal_code": "068115277",
"telephone_number": "203-798-7520"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENOVESE DRUG STORES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-22",
"last_updated": "2012-03-14",
"status": "A",
"authorized_official_last_name": "ZOREK",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
"authorized_official_telephone_number": "717-975-5937"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "1883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004228567",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "004231239",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "0719382",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RITE AID PHARMACY 10384",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Danbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.