Active NPI
Kcaid Pharmacy Inc
Doing business as Preferred Pharmacy
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1407108541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- KCAID PHARMACY INC
- Doing business as
- Preferred Pharmacy
- Practice address
- 1771 Broadway
Brooklyn, NY 11207 - Phone
- (718) 872-7717
- Fax
- (718) 872-7718
- NPI assigned
- Oct 14, 2012
- Last updated
- Mar 7, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jim Kozlik
- Title
- Manager
- Phone
- (718) 872-7717
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1771 Broadway
Brooklyn, NY 11207
Mailing address
1771 Broadway
Brooklyn, NY 11207-1611
Phone (718) 872-7717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5806332 | Other | NCPDP |
Other names 1
- Preferred Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130306000145 | NY | DME Supplier - Pharmacy | 1153576772 | Practice locations: Brooklyn, NY |
| O20171113001156 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 1153576772 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Kcaid Pharmacy Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350172800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1407108541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1771 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112071611",
"telephone_number": "718-872-7717",
"fax_number": "718-872-7718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1771 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11207",
"telephone_number": "718-872-7717",
"fax_number": "718-872-7718"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KCAID PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-14",
"last_updated": "2023-03-07",
"certification_date": "2022-03-21",
"status": "A",
"authorized_official_last_name": "KOZLIK",
"authorized_official_first_name": "JIM",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "718-872-7717",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5806332",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Preferred Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Preferred Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.