Active NPI
Mediciti Drugs Inc
- Pharmacy
- Ridgewood, NY
National Provider Identifier
1356493456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 025558
- Legal business name
- MEDICITI DRUGS INC
- Doing business as
- RIDGEWOOD PHARMACY
- Practice address
- 389 Onderdonk Ave
Ridgewood, NY 11385-1336 - Phone
- (718) 381-3622
- Fax
- (718) 381-7992
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Sadath Ulla Shareef, RPH
- Title
- Supervising Pharmacist
- Phone
- (718) 381-3622
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 025558 | NY | Primary |
Addresses
Primary practice location
389 Onderdonk Ave
Ridgewood, NY 11385-1336
Mailing address
389 Onderdonk Ave
Ridgewood, NY 11385-1336
Phone (718) 381-3622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02383755 | Medicaid | NY |
Other names 1
- RIDGEWOOD PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110303000093 | NY | DME Supplier - Pharmacy | 1850596875 | Practice locations: Ridgewood, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Mediciti Drugs Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Ridgewood, NY
- NPI 1699598375
-
- Durable Medical Equipment & Medical Supplies
- Maspeth, NY
- NPI 1487876843
Locations
389 Onderdonk Ave
Ridgewood, NY 11385
Phone (718) 381-3622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339027200000",
"number": "1356493456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "389 ONDERDONK AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851336",
"telephone_number": "718-381-3622",
"fax_number": "718-381-7992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "389 ONDERDONK AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851336",
"telephone_number": "718-381-3622",
"fax_number": "718-381-7992"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICITI DRUGS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-17",
"last_updated": "2012-06-07",
"status": "A",
"authorized_official_last_name": "SHAREEF",
"authorized_official_first_name": "SADATH",
"authorized_official_middle_name": "ULLA",
"authorized_official_title_or_position": "SUPERVISING PHARMACIST",
"authorized_official_telephone_number": "718-381-3622",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NY",
"license": "025558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02383755",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RIDGEWOOD PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.