Organization Active NPI

KHK Operating Corp

Doing business as Gusar's Pharmacy

  • Pharmacy
  • Monticello, NY
National Provider Identifier
1235112954
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
021919 Issued in NY
Legal business name
KHK OPERATING CORP
Doing business as
Gusar's Pharmacy
Practice address
458 Broadway
Monticello, NY 12701-1732
Phone
(845) 794-5757
Fax
(845) 794-3570
NPI assigned
Nov 28, 2005
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Mr. Emil Motl
Title
Supervising Pharmacist
Phone
(845) 794-5757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 021919 NY Primary

Addresses

Primary practice location

458 Broadway
Monticello, NY 12701-1732

Mailing address

458 Broadway
Monticello, NY 12701-1732
Phone (845) 794-5757

Other identifiers 2

IdentifierTypeStateIssuer
01442511MedicaidNY
3341435OtherNYNABP

Other names 1

  • Gusar's Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

458 Broadway
Monticello, NY 12701
Phone (845) 794-5757

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": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1235112954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 BROADWAY",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011732",
            "telephone_number": "845-794-5757",
            "fax_number": "845-794-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 BROADWAY",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011732",
            "telephone_number": "845-794-5757",
            "fax_number": "845-794-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHK OPERATING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "MOTL",
        "authorized_official_first_name": "EMIL",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "845-794-5757",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "021919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01442511",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3341435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gusar's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.