Organization Active NPI

Amboy Pharmacy Inc

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1366947186
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
AMBOY PHARMACY INC
Practice address
595 Bay St
Staten Island, NY 10304-3965
Phone
(718) 966-0083
Fax
(718) 966-0078
NPI assigned
Mar 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Mr. Ammad Khan
Title
President
Phone
(718) 966-0083

Specialties & licenses 1

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

Addresses

Primary practice location

595 Bay St
Staten Island, NY 10304-3965

Mailing address

595 Bay St
Staten Island, NY 10304-3965
Phone (718) 966-0083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221104000104 NY Part B Supplier - Pharmacy 7113276890 Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

7095 Amboy Rd
Staten Island, NY 10307
Phone (718) 966-0083

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1366947186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043965",
            "telephone_number": "718-966-0083",
            "fax_number": "718-966-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043965",
            "telephone_number": "718-966-0083",
            "fax_number": "718-966-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBOY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-25",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-966-0083",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.