Organization Active NPI

Moms RX Corporation

Doing business as Mom's Pharmacy RX

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1205425600
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MOMS RX CORPORATION
Doing business as
Mom's Pharmacy RX
Practice address
745 Ralph Ave Ste I
Brooklyn, NY 11212-3835
Phone
(347) 240-3750
Fax
(347) 240-3748
NPI assigned
Jan 12, 2021
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Dr. Mellissa Chen, PHARMDNPI 1336502368
Title
Owner
Phone
(954) 608-0528

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

745 Ralph Ave Ste I
Brooklyn, NY 11212-3835

Mailing address

745 Ralph Ave Ste I
Brooklyn, NY 11212-3835
Phone (347) 240-3750

Other names 1

  • Mom's Pharmacy RX Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220105000833 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1759783400 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

745 Ralph Ave
Ste 1
Brooklyn, NY 11212
Phone (347) 240-3750

745 Ralph Ave
Ste I
Brooklyn, NY 11212
Phone (347) 240-3750

Practitioners & affiliated clinicians

Practitioners 1

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": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1205425600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 RALPH AVE STE I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123835",
            "telephone_number": "347-240-3750",
            "fax_number": "347-240-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 RALPH AVE STE I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123835",
            "telephone_number": "347-240-3750",
            "fax_number": "347-240-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMS RX CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-608-0528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mom's Pharmacy RX",
            "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 Mar 29, 2022; 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.