Organization Active NPI

Guru Specialty Pharmacy Inc

  • Pharmacy
  • South Ozone Park, NY
National Provider Identifier
1407362510
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
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

Updated by the provider on Sep 27, 2023

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)CodeLicenseStatePrimary
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 NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 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.

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.

Verify at the official NPI Registry.