Organization Active NPI

Mead Square Pharmacy Inc

  • Community/Retail Pharmacy
  • Victor, NY
National Provider Identifier
1306912076
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MEAD SQUARE PHARMACY INC
Practice address
7249 State Route 96
Victor, NY 14564-9009
Phone
(585) 924-7970
Fax
(585) 924-8329
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Mr. Christopher Kevin Casey, R.PH.NPI 1437225190
Title
President
Phone
(585) 924-7970

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 025452 NY
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

7249 State Route 96
Victor, NY 14564-9009

Mailing address

7249 State Route 96
Victor, NY 14564-9009
Phone (585) 924-7970

Other identifiers 1

IdentifierTypeStateIssuer
02323724MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930061635 NY DME Supplier - Pharmacy 9739396862 Practice locations: Victor, NY
O20101214000153 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9739396862 Practice locations: Victor, NY

National Provider Directory

National Provider Directory
Tax ID family
Mead Square Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1306912076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7249 STATE ROUTE 96",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649009",
            "telephone_number": "585-924-7970",
            "fax_number": "585-924-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7249 STATE ROUTE 96",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649009",
            "telephone_number": "585-924-7970",
            "fax_number": "585-924-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEAD SQUARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-924-7970",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "025452",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02323724",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.

Verify at the official NPI Registry.