Russells Pharmacy Upstate Home Respiratory Equipment Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

RUSSELLS PHARMACY UPSTATE HOME RESPIRATORY EQUIPMENT INC

Practice address

106 Maple St
Corinth, NY 12822-1026

Phone

(518) 654-2485

Fax

(518) 654-7555

NPI assigned

Jul 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Carl Alexander Lawrence

Title

President

Phone

(518) 654-2485

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285668483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MAPLE ST",
            "city": "CORINTH",
            "state": "NY",
            "postal_code": "128221026",
            "telephone_number": "518-654-2485",
            "fax_number": "518-654-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MAPLE ST",
            "city": "CORINTH",
            "state": "NY",
            "postal_code": "128221026",
            "telephone_number": "518-654-2485",
            "fax_number": "518-654-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLS PHARMACY UPSTATE HOME RESPIRATORY EQUIPMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-654-2485",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10019380",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01240995",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02570643",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenelle Donzelli Nemeth, BSN, RN, IBCLC
• Michael Edward Nolan, DDS
• Nys Opwdd
• Nicole O'Brien
• Rite Aid of New York Inc (Rite Aid Pharmacy 02796)
• Perumunda Krishna Sharma, MD
• George C Siniapkin, MD
• Bohan B. Soifer, D.M.D.
• State of New York Comptrollers Office
• Amanda A Steen

• Customized Equipment (DME) in Corinth, NY
• Providers in Corinth, NY by specialty
• Customized Equipment (DME) 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.