Organization Active NPI

Wayne Drug of Pulaski, Inc

  • Community/Retail Pharmacy
  • Oswego, NY
National Provider Identifier
1275606097
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
019649 Issued in NY
Legal business name
WAYNE DRUG OF PULASKI, INC
Practice address
24 W Bridge St
Oswego, NY 13126-2051
Phone
(315) 343-5722
Fax
(315) 343-0085
NPI assigned
Nov 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James Patrick Branshaw, R.PH.NPI 1528191988
Title
Owner
Phone
(315) 343-5722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 019649 NY Primary

Addresses

Primary practice location

24 W Bridge St
Oswego, NY 13126-2051

Mailing address

24 W Bridge St
Oswego, NY 13126-2051
Phone (315) 343-5722

Other identifiers 1

IdentifierTypeStateIssuer
01252657MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140604000015 NY Part B Supplier - Mass Immunization (Roster Biller Only) 8123145554 Practice locations: Oswego, NY

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

24 W Bridge St
Oswego, NY 13126
Phone (315) 343-5722

Practitioners & affiliated clinicians

Practitioners 2

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275606097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 W BRIDGE ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262051",
            "telephone_number": "315-343-5722",
            "fax_number": "315-343-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W BRIDGE ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262051",
            "telephone_number": "315-343-5722",
            "fax_number": "315-343-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE DRUG OF PULASKI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRANSHAW",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-343-5722",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "019649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

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