Suburban Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHA00136 Issued in RI

Legal business name

SUBURBAN PHARMACY INC

Practice address

242 Pawtuxet Ave
Warwick, RI 02888-1933

Phone

(401) 781-2110

Fax

(401) 781-2640

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Nicholas Shanos, RPHNPI 1811581556

Title

Owner and President

Phone

(401) 781-2110

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SUBURBAN PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Shanos

  • Pharmacist
  • Warwick, RI
  • NPI 1811581556
  NPD Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1245373307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 PAWTUXET AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028881933",
            "telephone_number": "401-781-2110",
            "fax_number": "401-781-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 PAWTUXET AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028881933",
            "telephone_number": "401-781-2110",
            "fax_number": "401-781-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "SHANOS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "401-781-2110",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": "PHA00136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088084",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP00071",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUBURBAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Warwick, RI
• Providers in Warwick, RI by specialty
• Community/Retail Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.