Active NPI
Guru Specialty Pharmacy Inc
- Pharmacy
- South Ozone Park, NY
National Provider Identifier
1407362510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- GURU SPECIALTY PHARMACY INC
- Practice address
- 11804 Rockaway Blvd
South Ozone Park, NY 11420-2420 - Phone
- (718) 322-2228
- NPI assigned
- Dec 27, 2017
- 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. Imran Siddiqui
- Title
- President
- Phone
- (718) 322-2228
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
11804 Rockaway Blvd
South Ozone Park, NY 11420-2420
Mailing address
11804 Rockaway Blvd
South Ozone Park, NY 11420-2420
Phone (718) 322-2228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180725002796 | NY | DME Supplier - Pharmacy | 3072860782 | Practice locations: South Ozone Park, NY |
| O20250404001559 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 3072860782 | Practice locations: South Ozone Park, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Freeport, NY
- NPI 1821311762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514332800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695772800000",
"number": "1407362510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11804 ROCKAWAY BLVD",
"city": "SOUTH OZONE PARK",
"state": "NY",
"postal_code": "114202420",
"telephone_number": "718-322-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11804 ROCKAWAY BLVD",
"city": "SOUTH OZONE PARK",
"state": "NY",
"postal_code": "114202420",
"telephone_number": "718-322-2228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GURU SPECIALTY PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-27",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A",
"authorized_official_last_name": "SIDDIQUI",
"authorized_official_first_name": "IMRAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-322-2228",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Ozone Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.