Adirondack Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025407 Issued in NY

Legal business name

ADIRONDACK PHARMACY, INC.

Practice address

4057 State Highway 3
Star Lake, NY 13690-0211

Phone

(315) 848-3784

Fax

(315) 848-5129

NPI assigned

Oct 17, 2006

Last updated

Sep 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Scott, R.PH.NPI 1427139427

Title

President

Phone

(315) 848-3784

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

Practitioners 3

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.

• Matthew Scott, R.PH.

  • Pharmacist
  • Star Lake, NY
  • NPI 1427139427
  NPD Authorized official
• Lacey Scott

  • Pharmacist
  • Star Lake, NY
  • NPI 1629479720
  NPD
• Diane Birney Scott, RPH

  • Pharmacist
  • Star Lake, NY
  • NPI 1861710212
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1215018213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 STATE HIGHWAY 3",
            "address_2": "P.O. BOX 211",
            "city": "STAR LAKE",
            "state": "NY",
            "postal_code": "136903172",
            "telephone_number": "315-848-3784",
            "fax_number": "315-848-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 STATE HIGHWAY 3",
            "city": "STAR LAKE",
            "state": "NY",
            "postal_code": "136900211",
            "telephone_number": "315-848-3784",
            "fax_number": "315-848-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-848-3784",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025407",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "025407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02289669",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy Benzel, PT
• Clifton-Fine Central School
• Clifton-Fine Healthcare Corporation (Clifton-Fine Hospital)
• Clifton-Fine Healthcare Corporation
• Debra Lynn Hance, RN

• Community/Retail Pharmacy in Star Lake, NY
• Providers in Star Lake, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.