Molloy Medical Arts Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031697 Issued in NY

Legal business name

MOLLOY MEDICAL ARTS PHARMA INC

Doing business as

Molloy Medical Arts Pharmacy

Practice address

19 Baker Ave Ste 207
Ste 207
Poughkeepsie, NY 12601-1375

Phone

(845) 471-7455

Fax

(845) 473-6337

NPI assigned

Oct 2, 2012

Organization subpart

No

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

Authorized official

Name

Ganesh Krishnachand Talasila

Title

Pharmacy Manager

Phone

(845) 471-7455

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MOLLOY MEDICAL ARTS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Molloy Medical Arts Pharma Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Molloy Medical Arts Pharma Inc

  dba Molloy Medical Arts Pharmacy-LTC

  • Long Term Care Pharmacy
  • Poughkeepsie, NY
  • NPI 1194547562
  NPD tax ID

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1376894279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BAKER AVE",
            "address_2": "STE 207",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-471-7455",
            "fax_number": "845-473-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BAKER AVE STE 207",
            "address_2": "STE 207",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011375",
            "telephone_number": "845-471-7455",
            "fax_number": "845-473-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLLOY MEDICAL ARTS PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "TALASILA",
        "authorized_official_first_name": "GANESH KRISHNACHAND",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "845-471-7455"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "031697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03498666",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139794",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOLLOY MEDICAL ARTS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MOLLOY MEDICAL ARTS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Khaled I Mohamed, MD
• Samah Mohammed Musa Mohammed
• Tracy Mohrmann
• Briar Diane Molak
• Molloy Medical Arts Pharma Inc (Molloy Medical Arts Pharmacy-LTC)
• Molloy's Medical Arts Pharmacy, LLC
• Joan K Molomot, SLP
• Maureen Moloney
• Arundhuti Momen, M.D.
• Mojdeh Momeni, M.D.

• Community/Retail Pharmacy in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.