Full Care Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031020 Issued in NY

Legal business name

FULL CARE PHARMACY INC

Doing business as

Community Care Pharmacy

Practice address

2913 Surf Ave
Brooklyn, NY 11224-1705

Phone

(718) 372-5300

Fax

(718) 372-2451

NPI assigned

Aug 30, 2011

Organization subpart

No

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

Authorized official

Name

Rolson Chennamkara Abraham, BS PHARMNPI 1346673209

Title

President

Phone

(718) 372-5300

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Community Care Pharmacy Doing business as

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rolson Chennamkara Abraham, RPH

  • Pharmacist
  • Manhasset, NY
  • NPI 1346673209
  NPD Authorized official
• Pervez A. Siddiqui, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1396769170
  NPD (past)

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1306127816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 SURF AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241705",
            "telephone_number": "718-372-5300",
            "fax_number": "718-372-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 SURF AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241705",
            "telephone_number": "718-372-5300",
            "fax_number": "718-372-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "ROLSON",
        "authorized_official_middle_name": "CHENNAMKARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-372-5300",
        "authorized_official_credential": "BS PHARM"
    },
    "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": "031020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133603",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03368458",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moshe Saul Fuksbrumer, MD
• Mikhail Fukshansky, MD
• Cruz Yolande Fuksman, LMSW
• Alayna Fulco
• Zachary Fulenwider
• Full Circle Eip Inc
• Full Circle Psychology PLLC
• Full Healthcare Pharmacy, Inc
• Fuller Home Care Agency
• Fuller Smiles PLLC

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 Dec 10, 2021; 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.