Crown Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034371 Issued in NY

Legal business name

CROWN PHARMA INC

Practice address

4020 82ND St
Elmhurst, NY 11373-1305

Phone

(718) 426-2525

Fax

(718) 426-2523

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Shivakumar Pinnoju, RPH

Title

Pharmacy Manager / Pharmacist

Phone

(718) 426-2525

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LAVIDA PHARMACY Other name

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Crown Pharma Inc2 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.

• Crown Pharma Inc

  • Long Term Care Pharmacy
  • Elmhurst, NY
  • NPI 1609712819
  NPD tax ID

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1245699644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-2525",
            "fax_number": "718-426-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-2525",
            "fax_number": "718-426-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "PINNOJU",
        "authorized_official_first_name": "SHIVAKUMAR",
        "authorized_official_title_or_position": "PHARMACY MANAGER / PHARMACIST",
        "authorized_official_telephone_number": "718-426-2525",
        "authorized_official_name_prefix": "Mr.",
        "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": "NY",
            "license": "034371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407146855",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164047",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAVIDA PHARMACY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "LAVIDA PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yazmin Alondra Coyomani
• Kaitlin Marie Crandall, LCSW
• Megan Elizabeth Crants
• Arminda Berongoy Crisostomo
• Kristine Crisostomo
• Crown Pharma Inc
• Crown Pharmacy Inc
• Carmen Cruz Quintero, NP
• Mayte Cruz Zermeno, MD
• Jomarie Cruz

• Community/Retail Pharmacy in Elmhurst, NY
• Providers in Elmhurst, 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 Oct 6, 2020; 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.