Organization Active NPI

SSS Pharmacy Inc

  • Pharmacy
  • New York, NY
National Provider Identifier
1184909855
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
031103 Issued in NY
Legal business name
SSS PHARMACY INC
Practice address
66 Nagle Ave
New York, NY 10040-1406
Phone
(212) 304-3949
Fax
(212) 304-4339
NPI assigned
Oct 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Sirisha Mallidi
Title
President
Phone
(212) 304-3949

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 031103 NY Primary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

66 Nagle Ave
New York, NY 10040-1406

Mailing address

66 Nagle Ave
New York, NY 10040-1406
Phone (212) 304-3949

Other identifiers 2

IdentifierTypeStateIssuer
01584358MedicaidNY
2133774OtherPK

Other names 1

  • sss pharmacy inc Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120622000359 NY DME Supplier - Pharmacy 4981869013 Practice locations: New York, NY
O20180604000943 NY Part B Supplier - Mass Immunization (Roster Biller Only) 4981869013 Practice locations: New York, 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
SSS Pharmacy Inc66 Nagle Ave, New York, NY 10040-1406(212) 304-3949 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since May 16, 2018

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1184909855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401406",
            "telephone_number": "212-304-3949",
            "fax_number": "212-304-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401406",
            "telephone_number": "212-304-3949",
            "fax_number": "212-304-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "MALLIDI",
        "authorized_official_first_name": "SIRISHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-304-3949"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "031103",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01584358",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133774",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sss pharmacy inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.