NPIMap

Organization Active NPI

Gerould'S Professional Pharmacy Inc.

  • Community/Retail Pharmacy
  • Elmira, NY
National Provider Identifier
1184658353
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
000831 Issued in NY
Legal business name
GEROULD'S PROFESSIONAL PHARMACY INC.
Practice address
130 S Main St
Elmira, NY 14904-1309
Phone
(607) 732-0597
Fax
(607) 732-7911
NPI assigned
Jul 11, 2006
Organization subpart
Yes
Parent organization
GEROULD'S PROFESSIONAL PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Authorized official

Name
Mr. Frank T Steed, RPH.
Title
VP
Phone
(607) 732-0597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 000831 NY Primary

Addresses

Primary practice location

130 S Main St
Elmira, NY 14904-1309

Mailing address

PO Box 4067
Elmira, NY 14904-0067
Phone (607) 732-0597

Other identifiers 2

IdentifierTypeStateIssuer
3316646OtherNYNABP
00358801MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100823000002 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2365576683 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corning, NY; Elmira, NY; Horseheads, NY
O20100930082759 NY DME Supplier - Pharmacy 2365576683 Practice locations: Elmira, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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 Directory
Tax ID family
Geroulds Surgical Suppl8 organizations share this tax ID, including this one
Part of
Geroulds Surgical Suppl

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1184658353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4067",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149040067",
            "telephone_number": "607-732-0597",
            "fax_number": "607-733-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149041309",
            "telephone_number": "607-732-0597",
            "fax_number": "607-732-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEROULD'S PROFESSIONAL PHARMACY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEROULD'S PROFESSIONAL PHARMACY INC.",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "STEED",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "607-732-0597",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "000831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3316646",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00358801",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.