NPIMap

Organization Active NPI

Pharmaceutic Labs, LLC

  • Clinical Medical Laboratory
  • Albany, NY
National Provider Identifier
1366843476
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
059848 Issued in NY
Legal business name
PHARMACEUTIC LABS, LLC
Practice address
15 Walker Way
Albany, NY 12205-4945
Phone
(518) 608-1060
Fax
(518) 608-6109
NPI assigned
Sep 8, 2014
Reactivated
May 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Samantha Mattison
Title
Pharmacist
Phone
(518) 608-1060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 059848 NY Primary

Addresses

Primary practice location

15 Walker Way
Albany, NY 12205-4945

Mailing address

15 Walker Way
Albany, NY 12205-4945
Phone (518) 608-1060

National Provider Directory

National Provider Directory
Tax ID family
Pharmaceutic Labs LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1366843476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054945",
            "telephone_number": "518-608-1060",
            "fax_number": "518-608-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054945",
            "telephone_number": "518-608-1060",
            "fax_number": "518-608-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACEUTIC LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2015-05-13",
        "deactivation_date": "2014-09-16",
        "reactivation_date": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "MATTISON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "518-608-1060"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "059848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.