Organization Active NPI

Ryan Drugs LLC

Doing business as Valley Drugs

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1407180391
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
029680 Issued in NY
Legal business name
RYAN DRUGS LLC
Doing business as
Valley Drugs
Practice address
801 Amsterdam Ave
New York, NY 10025-5752
Phone
(212) 678-0084
Fax
(212) 678-0086
NPI assigned
Sep 24, 2009
Last updated
Jan 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Sunil Mandalapu
Title
President
Phone
(212) 678-0084

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 029680 NY Primary

Addresses

Primary practice location

801 Amsterdam Ave
New York, NY 10025-5752

Mailing address

801 Amsterdam Ave
New York, NY 10025-5752
Phone (212) 678-0084

Other identifiers 2

IdentifierTypeStateIssuer
2122225OtherPK
3157155MedicaidNY

Other names 1

  • Valley Drugs Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930035656 NY DME Supplier - Pharmacy 0648460972 Practice locations: New York, NY
O20150401001648 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0648460972 Practice locations: New York, NY
O20220418000480 NY Part B Supplier - Pharmacy 0648460972 Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1407180391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255752",
            "telephone_number": "212-678-0084",
            "fax_number": "212-678-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255752",
            "telephone_number": "212-678-0084",
            "fax_number": "212-678-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN DRUGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "MANDALAPU",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-678-0084"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122225",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Drugs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.