NPIMap

Organization Active NPI

Duane Reade

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1265458376
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
025077 Issued in NY
Legal business name
DUANE READE
Practice address
105 Brighton Beach Ave
Brooklyn, NY 11235-8001
Phone
(718) 449-9188
Fax
(718) 449-9214
NPI assigned
Jul 14, 2006
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
Kira Taylor
Title
Manager
Phone
(217) 709-2351

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 025077 NY Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

105 Brighton Beach Ave
Brooklyn, NY 11235-8001

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other identifiers 2

IdentifierTypeStateIssuer
3321419OtherOTHER ID NUMBER-COMMERCIAL NUMBER
02161195MedicaidNY

Other names 1

  • DUANE READE #14285 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222000409 TX Part B Supplier - Centralized Flu Biller 3971644642 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Walgreens Holding Company

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1265458376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2351",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BRIGHTON BEACH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358001",
            "telephone_number": "718-449-9188",
            "fax_number": "718-449-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE READE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KIRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2351"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "025077",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3321419",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02161195",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUANE READE #14285",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DUANE READE #14285",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.