NPIMap

Organization Active NPI

Shore Pharmaceutical Providers LLC

Doing business as Omnicare of Plainview

  • Long Term Care Pharmacy
  • Plainview, NY
National Provider Identifier
1184648511
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
SHORE PHARMACEUTICAL PROVIDERS LLC
Doing business as
Omnicare of Plainview
Omnicare of Plainview #48313
Practice address
55 W Ames CT
Suite 200
Plainview, NY 11803-2304
Phone
(516) 938-8080
NPI assigned
Jul 27, 2006
Last updated
Mar 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Susan Colbert
Title
Sr Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

55 W Ames CT
Suite 200
Plainview, NY 11803-2304

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146

Other names 2

  • Omnicare of Plainview Doing business as
  • Omnicare of Plainview #48313 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930007806 NY DME Supplier - Pharmacy 9739209065 Practice locations: Plainview, NY
O20231129001082 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9739209065 Practice locations: Plainview, 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
Shore Pharmaceutical Providers55W Ames CT, Plainview, NY 11803-2304(516) 938-8080 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 2009

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

55 W Ames Ct
Ste 200
Plainview, NY 11803
Phone (516) 938-8080

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1184648511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W AMES CT",
            "address_2": "SUITE 200",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118032304",
            "telephone_number": "516-938-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE PHARMACEUTICAL PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omnicare of Plainview",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omnicare of Plainview #48313",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.