Organization Active NPI

Pharm J Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1184721029
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
020772 Issued in NY
Legal business name
PHARM J INC
Practice address
1205 Avenue J
Brooklyn, NY 11230-3603
Phone
(718) 258-6686
Fax
(718) 258-2360
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Larry Birnbaum, RPH
Title
Owner, Pres
Phone
(718) 258-6686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 020772 NY Primary

Addresses

Primary practice location

1205 Avenue J
Brooklyn, NY 11230-3603

Mailing address

1205 Avenue J
Brooklyn, NY 11230-3603
Phone (718) 258-6686

Other identifiers 2

IdentifierTypeStateIssuer
01235827MedicaidNY
2066812OtherPK

Other names 1

  • J DRUGS Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091103000298 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0143368639 Practice locations: Brooklyn, NY
O20100930016080 NY DME Supplier - PharmacyDME Supplier - Oxygen & Equipment 0143368639 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1205 Avenue J
Brooklyn, NY 11230
Phone (718) 258-6686

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1184721029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303603",
            "telephone_number": "718-258-6686",
            "fax_number": "718-258-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303603",
            "telephone_number": "718-258-6686",
            "fax_number": "718-258-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARM J INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "BIRNBAUM",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER, PRES",
        "authorized_official_telephone_number": "718-258-6686",
        "authorized_official_credential": "RPH"
    },
    "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": "020772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01235827",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066812",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

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