NPIMap

Organization Active NPI

Auburn Community Hospital

  • Community/Retail Pharmacy
  • Auburn, NY
National Provider Identifier
1366923534
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
000768 Issued in NY
Legal business name
AUBURN COMMUNITY HOSPITAL
Practice address
17 Lansing Street
Pharmacy
Auburn, NY 13021-1983
Phone
(315) 255-7307
Fax
(315) 255-7020
NPI assigned
Aug 27, 2018
Last updated
Mar 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
AUBURN COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Christopher D Ryan
Title
Cio
Phone
(315) 253-1760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 000768 NY Primary

Addresses

Primary practice location

17 Lansing Street
Pharmacy
Auburn, NY 13021-1983

Mailing address

17 Lansing Street
Pharmacy
Auburn, NY 13021-1983
Phone (315) 255-7307

Other identifiers 1

IdentifierTypeStateIssuer
00347553MedicaidNY

Other names 1

  • Auburn Community Hospital / Pharmacy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210422000114 NY Part B Supplier - Pharmacy 2365346525 Practice locations: Auburn, NY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Auburn Memorial Hospital7 organizations share this tax ID, including this one
Part of
Auburn Memorial Hospital

Other organizations with this tax ID 6

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": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1366923534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING STREET",
            "address_2": "PHARMACY",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7307",
            "fax_number": "315-255-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING STREET",
            "address_2": "PHARMACY",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7307",
            "fax_number": "315-255-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUBURN COMMUNITY HOSPITAL",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "315-253-1760"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "000768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00347553",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Auburn Community Hospital / Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Auburn Community Hospital / Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.