Apollo Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035752 Issued in NY

Legal business name

APOLLO PHARMA INC

Practice address

98 E Broadway Apt 1F
New York, NY 10002-7093

Phone

(212) 431-6688

Fax

(212) 431-6681

NPI assigned

Aug 3, 2017

Last updated

Sep 29, 2022By 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

Daniel Bastien

Title

Supervising Pharmacist

Phone

(212) 431-6688

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EAST BROADWAY PHARMACY Other name

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1295259927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 E BROADWAY APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027093",
            "telephone_number": "212-431-6688",
            "fax_number": "212-431-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E BROADWAY APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027093",
            "telephone_number": "212-431-6688",
            "fax_number": "212-431-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "BASTIEN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "212-431-6688"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2172114",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04876775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST BROADWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EAST BROADWAY PHARMACY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "EAST BROADWAY PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Caitlin Leilani Apollo, PT, DPT
• Stephanie Apolo

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.