1413 Fulton St Pharmacy, Corp.

Primary specialty

PharmacistTaxonomy code 183500000X

License

015396 Issued in NY

Legal business name

1413 FULTON ST PHARMACY, CORP.

Practice address

1413 Fulton St
Brooklyn, NY 11216-2607

Phone

(718) 638-5088

Fax

(516) 371-1814

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Allan Berman, RPH.

Title

Tres.

Phone

(718) 638-5088

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

1413 Fulton St Pharmacy2 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.

• 1413 Fulton St Pharmacy

  • Community/Retail Pharmacy
  • Brooklyn, NY
  • NPI 1760669261
  NPD tax ID

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275664302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162607",
            "telephone_number": "718-638-5088",
            "fax_number": "516-371-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162607",
            "telephone_number": "718-638-5088",
            "fax_number": "516-371-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1413 FULTON ST PHARMACY, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "TRES.",
        "authorized_official_telephone_number": "718-638-5088",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "015396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00263185",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1325 Fifth Ave Drugs Inc
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• 13TH Ave Pharmacy Inc.
• 1413 Fulton St Pharmacy
• 1413 RX Ny LLC
• 1413 RX Ny LLC
• 147TH Road Block Commumity Association
• 1491 Dekalb Ave Pharmacy Inc
• 1501 Medical PC

• Pharmacist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pharmacist in New York

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.