Brewerton Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

019361 Issued in NY

Legal business name

BREWERTON PHARMACY INC

Practice address

9679 Brewerton Rd
Brewerton, NY 13029-8738

Phone

(315) 676-4441

Fax

(315) 676-5255

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Nicholas Chervinsky, RPHNPI 1306006572

Title

President

Phone

(315) 676-4441

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• BREWERTON PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 5

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

• Nicholas Chervinsky, RPH

  • Pharmacist
  • Brewerton, NY
  • NPI 1306006572
  NPD Authorized official
• Michelle Rose Avezzano, PHARM D

  • Pharmacist
  • Brewerton, NY
  • NPI 1205473758
  NPD (past)
• Ryan Norton

  • Pharmacist
  • Brewerton, NY
  • NPI 1780451633
  NPD (past)
• Nicole Parrish, RPH

  • Pharmacist
  • Cicero, NY
  • NPI 1851613269
  NPD (past)
• Stephanie Sessa, RPH

  • Pharmacist
  • Brewerton, NY
  • NPI 1417289323
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1407950462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9679 BREWERTON RD",
            "city": "BREWERTON",
            "state": "NY",
            "postal_code": "130298738",
            "telephone_number": "315-676-4441",
            "fax_number": "315-676-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9679 BREWERTON RD",
            "city": "BREWERTON",
            "state": "NY",
            "postal_code": "130298738",
            "telephone_number": "315-676-4441",
            "fax_number": "315-676-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREWERTON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "CHERVINSKY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-676-4441",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "019361",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2062896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00580149",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BREWERTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Bishop, M.S.
• Thomas Blount, DDS
• Dalaine Bouthillier, LPN
• Ann Marie Bower, RN
• Brewerton Family Dentistry
• Brewerton Volunteer Fire Department Ambulance Inc
• Brett R Bunker, P.A.
• Jason Vincent Calcara, MS, OTR/L
• Thomas Mark Carroll, DDS
• Alexia Lynn Cavanaugh, FNP

• All providers in Brewerton, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.