Organization Active NPI

Connectrx Latham, LLC

  • Community/Retail Pharmacy
  • Latham, NY
National Provider Identifier
1225793151
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CONNECTRX LATHAM, LLC
Practice address
6 Wellness Way Ste 104
Latham, NY 12110-2156
Phone
(518) 313-1016
Fax
(518) 313-0790
NPI assigned
Nov 4, 2021
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Debra Marie Hotaling, R.PH.
Title
Director
Phone
(518) 273-1402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

6 Wellness Way Ste 104
Latham, NY 12110-2156

Mailing address

711 Troy Schenectady Rd Ste 109
Latham, NY 12110-2454
Phone (518) 313-1016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220608001433 NY Part B Supplier - Pharmacy 1052799707 Practice locations: Latham, NY
O20220707000243 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1052799707 Practice locations: Latham, NY
O20250522000901 NY DME Supplier - Pharmacy 1052799707 Practice locations: Latham, NY

National Provider Directory

National Provider Directory
Tax ID family
Connectrx Latham LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1225793151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 109",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102454",
            "telephone_number": "518-313-1016",
            "fax_number": "518-313-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 104",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-313-1016",
            "fax_number": "518-313-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTRX LATHAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "HOTALING",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-273-1402",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.