Individual provider Active NPI

Vyacheslav Steve Shamalov, RPH

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1275706798
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050505-1 Issued in NY
Practice address
3741 Riverdale Ave
Bronx, NY 10463-1807
Phone
(718) 549-6709
Fax
(718) 549-1422
NPI assigned
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 050505-1 NY Primary
Pharmacist 183500000X 28RI02896100 NJ

Addresses

Primary practice location

3741 Riverdale Ave
Bronx, NY 10463-1807

Mailing address

3741 Riverdale Ave
Bronx, NY 10463-1807
Phone (718) 549-6709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI02896100NJMDPharmacist
050505-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
River Chemists Corp. Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1275706798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 RIVERDALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631807",
            "telephone_number": "718-549-6709",
            "fax_number": "718-549-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 RIVERDALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631807",
            "telephone_number": "718-549-6709",
            "fax_number": "718-549-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMALOV",
        "first_name": "VYACHESLAV",
        "middle_name": "STEVE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050505-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02896100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.