Medical Group Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

017633 Issued in NY

Legal business name

MEDICAL GROUP PHARMACY INC

Practice address

650 Hawkins Ave
Lake Ronkonkoma, NY 11779-2366

Phone

(631) 588-8582

Fax

(631) 588-8599

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Paul Autler, RPH

Title

Supervising Pharmacist

Phone

(631) 588-8582

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306941380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792366",
            "telephone_number": "631-588-8582",
            "fax_number": "631-588-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792366",
            "telephone_number": "631-588-8582",
            "fax_number": "631-588-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AUTLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "631-588-8582",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "017633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPOP",
            "identifier": "3375501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James McGovern, O.D.
• Meagan McGuigan, L.P.N.
• Jenna M McKenzie, FNP
• Nicole McLaughlin
• Medi Active Wheels LLC
• Mitchell Elliott Mehlman
• Melody a Espiritu Physical Therapist PC
• Farrah L Merendina, RPH
• Kimberly Messina, P.T.
• Mariam Millian Meyers, PHARM.D

• Community/Retail Pharmacy in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.