Organization Active NPI

B R G Chemists Inc

Doing business as Lafayette Pharmacy

  • Community/Retail Pharmacy
  • Williston Park, NY
National Provider Identifier
1346388337
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
015586 Issued in NY
Legal business name
B R G CHEMISTS INC
Doing business as
Lafayette Pharmacy
Practice address
330 Hillside Ave
Williston Park, NY 11596-2104
Phone
(516) 746-0646
Fax
(516) 742-8273
NPI assigned
Feb 2, 2007
Last updated
Nov 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Authorized official

Name
Maryellen McLaughlin
Title
President
Phone
(516) 746-0646

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 015586 NY Primary

Addresses

Primary practice location

330 Hillside Ave
Williston Park, NY 11596-2104

Mailing address

330 Hillside Ave
Williston Park, NY 11596-2104
Phone (516) 746-0646

Other identifiers 2

IdentifierTypeStateIssuer
00397026MedicaidNY
3300061OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • LAFAYETTE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212000817 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7214275585 Practice locations: Williston Park, NY

National Provider Directory

National Provider Directory

Locations

330 Hillside Ave
Williston Park, NY 11596
Phone (516) 746-0646

Practitioners & affiliated clinicians

Practitioners 3

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1346388337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HILLSIDE AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962104",
            "telephone_number": "516-746-0646",
            "fax_number": "516-742-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HILLSIDE AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962104",
            "telephone_number": "516-746-0646",
            "fax_number": "516-742-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B R G CHEMISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "MARYELLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-746-0646"
    },
    "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": "015586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00397026",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3300061",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAFAYETTE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.