Martins Foods of South Burlington LLC
Organization Active NPI Community/Retail Pharmacy · Kingston, NY
NPI 1205944683 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1205944683
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 022122 (NY)
- Legal business name
- MARTINS FOODS OF SOUTH BURLINGTON LLC
- Practice address
- 1261 Ulster Ave
Kingston, NY 12401-1527 - Phone
- (845) 336-0292
- Fax
- (845) 383-0287
- NPI assigned
- Aug 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Michael Vail
- Title
- President and Manager
- Phone
- (207) 885-7454
Other NPIs on the same Medicare enrollment 45
Corporate family (same tax ID) 21
Practitioners 5
-
Peter Joseph Errico, PHARMD
-
Carson Hardy, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hannaford Supermarket Pharmacy 8348 |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930096184 | NY | DME Supplier - Pharmacy |
7517085293 | Practice locations: Kingston, NY |
| O20111031000005 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 7517085293 |
45 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Hartford, NY; New Windsor, NY; Niskayuna, NY; Oneonta, NY; Pawling, NY; Pine Bush, NY; Plattsburgh, NY; Queensbury, NY… |
National Provider Directory
- Tax ID family
- Shop N Save Pharmacy
Locations
1261 Ulster Ave
Kingston, NY 12401
Phone (845) 336-0292
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 022122 | NY | Yes |
Addresses
Primary practice location
1261 Ulster Ave
Kingston, NY 12401-1527
Mailing address
PO Box 1000
Ms 3000
Portland, ME 04104-5005
Phone (207) 885-7454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01498351 | Medicaid | NY | |
| 2065632 | Other | PK |
Other names
- HANNAFORD FOOD AND DRUG
Other providers in Kingston, NY
- Pamela A Marshall
- Andrew Wood Martin
- Nicole Martin
- Estefania Martinez
- Alexandre Gomes Martinho
- Martins Foods of South Burlington LLC
- Cari Marvelli
- Benjamin Marx
- Julia Nani Marzano
- Frank Anthony Maschio
All providers in Kingston, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.