NPIMap

Organization Active NPI

The Chautauqua Center, Inc.

Doing business as South Dayton Pharmacy

  • Community/Retail Pharmacy
  • South Dayton, NY
National Provider Identifier
1376694224
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THE CHAUTAUQUA CENTER, INC.
Doing business as
South Dayton Pharmacy
Practice address
303 Pine St
South Dayton, NY 14138-0290
Phone
(716) 988-3410
Fax
(716) 988-3720
NPI assigned
Jan 16, 2007
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Michael C Pease
Title
Ceo
Phone
(716) 363-6890

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040701 NY
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

303 Pine St
South Dayton, NY 14138-0290

Mailing address

P.O. Box 290
303 Pine St
South Dayton, NY 14138-0290
Phone (716) 988-3410

Other names 1

  • South Dayton Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20250113000740 NY Part B Supplier - Pharmacy 7214178326 Practice locations: South Dayton, NY
O20250414002633 NY DME Supplier - Pharmacy 7214178326 Practice locations: South Dayton, NY
O20251121000333 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7214178326 2 other NPIs on this enrollment
Practice locations: South Dayton, NY; Dunkirk, NY; Jamestown, NY

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Chautauqua Center, Inc303 Pine St, South Dayton, NY 14138-9776(716) 988-3410 Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Feb 16, 2013

National Provider Directory

National Provider Directory
Tax ID family
The Chautauqua Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1376694224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 290",
            "address_2": "303 PINE ST",
            "city": "SOUTH DAYTON",
            "state": "NY",
            "postal_code": "141380290",
            "telephone_number": "716-988-3410",
            "fax_number": "716-988-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PINE ST",
            "city": "SOUTH DAYTON",
            "state": "NY",
            "postal_code": "141380290",
            "telephone_number": "716-988-3410",
            "fax_number": "716-988-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHAUTAUQUA CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "PEASE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-363-6890"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040701",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Dayton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Dayton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.