Active NPI
Maxi Drug Inc
- Community/Retail Pharmacy
- Monroe, CT
National Provider Identifier
1285734616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 1366
- Legal business name
- MAXI DRUG INC
- Practice address
- 435 Main Street
Monroe, CT 06468-1151 - Phone
- (203) 268-1098
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer M Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 1366 | CT | Primary |
Addresses
Primary practice location
435 Main Street
Monroe, CT 06468-1151
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004136835 | Medicaid | CT | |
| 004244480 | Other | CT | MEDICAID DME |
| 0715815 | Other | NCPDP |
Other names 1
- RITE AID PHARMACY 10370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200522000778 | CT | Part B Supplier - Pharmacy | 0042254898 |
11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bethel, CT; Cheshire, CT; Fairfield, CT; Hamden, CT; Milford, CT; Monroe, CT; North Branford, CT; Northford, CT… |
Other NPIs on the same Medicare enrollment 11
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329091200000",
"number": "1285734616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NEWBERRY COMMONS",
"city": "ETTERS",
"state": "PA",
"postal_code": "173199363",
"telephone_number": "717-761-2633",
"fax_number": "717-975-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 MAIN STREET",
"city": "MONROE",
"state": "CT",
"postal_code": "064681151",
"telephone_number": "203-268-1098"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAXI DRUG INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-25",
"last_updated": "2012-02-13",
"status": "A",
"authorized_official_last_name": "ZOREK",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
"authorized_official_telephone_number": "717-975-5937"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "1366",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004136835",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "004244480",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "0715815",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RITE AID PHARMACY 10370",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Monroe, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.