Organization Active NPI

Bethpage Pharmacy Inc

  • Community/Retail Pharmacy
  • Bethpage, NY
National Provider Identifier
1295875128
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
025594 Issued in NY
Legal business name
BETHPAGE PHARMACY INC
Practice address
334 Broadway
Bethpage, NY 11714-3007
Phone
(516) 931-1481
Fax
(516) 931-1489
NPI assigned
Feb 8, 2007
Last updated
Sep 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Authorized official

Name
Mr. Steve Jacobson, RPHNPI 1598831414
Title
Head Pharmacist
Phone
(516) 931-1481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 025594 NY Primary

Addresses

Primary practice location

334 Broadway
Bethpage, NY 11714-3007

Mailing address

334 Broadway
Bethpage, NY 11714-3007
Phone (516) 931-1481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170926001795 NY Part B Supplier - Pharmacy 0143594671 Practice locations: Bethpage, NY
O20180725000458 NY DME Supplier - Pharmacy 0143594671 Practice locations: Bethpage, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Bethpage Pharmacy Inc334 Broadway, Bethpage, NY 11714-3007(516) 931-1481 Oral Antiemetic Drugs Does not accept assignmentParticipating since Jun 6, 2017

National Provider Directory

National Provider Directory

Locations

334 Broadway
Bethpage, NY 11714
Phone (516) 931-1481

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1295875128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 BROADWAY",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143007",
            "telephone_number": "516-931-1481",
            "fax_number": "516-931-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BROADWAY",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143007",
            "telephone_number": "516-931-1481",
            "fax_number": "516-931-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHPAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "HEAD PHARMACIST",
        "authorized_official_telephone_number": "516-931-1481",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.