Richmond Valley Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032248 Issued in NY

Legal business name

RICHMOND VALLEY PHARMACY INC

Doing business as

Richmond Valley Pharmacy Inc.

Practice address

4888 Arthur Kill Rd
Staten Island, NY 10309-2633

Phone

(718) 967-9607

Fax

(718) 967-9620

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

Islam Mohamed

Title

President

Phone

(718) 967-9607

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Richmond Valley Pharmacy Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dalia N Boulos, R.PH

  • Pharmacist
  • New York, NY
  • NPI 1932381027
  NPD
• Omar Dobie

  • Pharmacist
  • Staten Island, NY
  • NPI 1750985578
  NPD (past)
• Barry Jonathan Goldman, MSPT

  • Physical Therapist
  • Staten Island, NY
  • NPI 1063585735
  NPD (past)
• Todd Matthew Wohl, MSPT

  • Physical Therapist
  • Staten Island, NY
  • NPI 1922172584
  NPD (past)

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624060800000",
    "number": "1407285216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4888 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092633",
            "telephone_number": "718-967-9607",
            "fax_number": "718-967-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4888 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092633",
            "telephone_number": "718-967-9607",
            "fax_number": "718-967-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND VALLEY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ISLAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-967-9607"
    },
    "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": "032248",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03818077",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richmond Valley Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Richmond Valley Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richmond University Medical Center
• Richmond University Medical Center
• Richmond University Medical Center
• Richmond University Medical Center
• Richmond University Medical Center Adolescent Program
• Bluma Richt
• Cora B Richter, LCSW
• David Matthew Rick, MHC-LP
• Shannon Rick
• Lawan Rickenbacker, PSYD

• Community/Retail Pharmacy in Staten Island, NY
• Providers in Staten Island, 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 Jun 19, 2021; 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.