Organization Active NPI

Elmway Pharmacy Inc

  • Pharmacist
  • Elmhurst, NY
National Provider Identifier
1306948724
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
025339 Issued in NY
Legal business name
ELMWAY PHARMACY INC
Practice address
8245 Broadway
Elmhurst, NY 11373
Phone
(718) 803-2288
Fax
(718) 429-4199
NPI assigned
Sep 5, 2006
Last updated
Apr 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Phoebe Tse, RPHNPI 1962681395
Title
V President
Phone
(718) 803-2288

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
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 025339 NY Primary

Addresses

Primary practice location

8245 Broadway
Elmhurst, NY 11373

Mailing address

8245 Broadway
Elmhurst, NY 11373
Phone (718) 803-2288

Other identifiers 1

IdentifierTypeStateIssuer
02254786MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930016307 NY DME Supplier - PharmacyDME Supplier - Oxygen & EquipmentDME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 7214140722 Practice locations: Elmhurst, NY
O20120810000000 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7214140722 Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Locations

8245 Broadway
Elmhurst, NY 11373
Phone (718) 803-2288

Practitioners & affiliated clinicians

Practitioners 8

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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1306948724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8245 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-803-2288",
            "fax_number": "718-429-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8245 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-803-2288",
            "fax_number": "718-429-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMWAY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "TSE",
        "authorized_official_first_name": "PHOEBE",
        "authorized_official_title_or_position": "V PRESIDENT",
        "authorized_official_telephone_number": "718-803-2288",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "025339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02254786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.