Organization Active NPI

Liberty Rock Pharmacy, Inc.

  • Community/Retail Pharmacy
  • South Richmond Hill, NY
National Provider Identifier
1396047544
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LIBERTY ROCK PHARMACY, INC.
Practice address
11806 101St Ave
South Richmond Hill, NY 11419-1230
Phone
(718) 880-2500
Fax
(718) 880-2501
NPI assigned
Nov 20, 2010
Last updated
Jan 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Dr. Aparna Rathod, PHARMD, RPH
Title
Supervising Pharmacist
Phone
(718) 880-2500

Specialties & licenses 1

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

Addresses

Primary practice location

11806 101St Ave
South Richmond Hill, NY 11419-1230

Mailing address

11806 101St Ave
South Richmond Hill, NY 11419-1230
Phone (718) 880-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110314000728 NY DME Supplier - Pharmacy 7618159575 Practice locations: South Richmond Hill, NY
O20210125000715 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7618159575 Practice locations: South Richmond Hill, NY

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
Suredrugs Pharmacy11806 101St Ave, South Richmond Hill, NY 11419-1230(718) 880-2500 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Feb 7, 2011

National Provider Directory

National Provider Directory

Locations

9603 Rockaway Blvd
Ozone Park, NY 11417
Phone (718) 880-2500

11806 101st Ave
South Richmond Hill, NY 11419
Phone (718) 880-2500

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": "1290211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1396047544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11806 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191230",
            "telephone_number": "718-880-2500",
            "fax_number": "718-880-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11806 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191230",
            "telephone_number": "718-880-2500",
            "fax_number": "718-880-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ROCK PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-20",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "RATHOD",
        "authorized_official_first_name": "APARNA",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-880-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.