St George Pharmacy Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

034093 Issued in NY

Legal business name

ST GEORGE PHARMACY INC

Practice address

99 Stuyvesant PL
Staten Island, NY 10301-1917

Phone

(718) 447-0333

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Omar S. Mohamed, PHARMD

Title

President

Phone

(718) 447-0333

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

St George 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.

• St George Pharmacy Inc

  • Long Term Care Pharmacy
  • Staten Island, NY
  • NPI 1770394397
  NPD tax ID

Locations

Practitioners 1

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

• Alphonse A Gentile Jr., RPH.

  • Pharmacist
  • Staten Island, NY
  • NPI 1285959759
  NPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1336265396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 STUYVESANT PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011917",
            "telephone_number": "718-447-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 STUYVESANT PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011917",
            "telephone_number": "718-447-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-447-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "034093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02566301",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Anushini Sriskanda
• Nicole Sriskanda, CHT
• Saroj Srivastava
• St Dental
• St George Counseling Services LCSW PLLC
• St George Pharmacy Inc
• St Josephs Physical Therapy PC
• St Kyrollos Physical Therapy PC
• Margaret-Ann Valerie St Louis, RN
• St Marks Dental PC

• Pharmacist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.