NPIMap

Organization Active NPI

Park Ridge Apothecary, Inc

  • Long Term Care Pharmacy
  • Rochester, NY
National Provider Identifier
1417022526
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
021849 Issued in NY
Legal business name
PARK RIDGE APOTHECARY, INC
Doing business as
Parkway Apothecary
Practice address
89 Genesee St
Rochester, NY 14611-3201
Phone
(585) 368-3930
Fax
(585) 368-3933
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Warren Hern
Title
Executive Vice President Cfo
Phone
(585) 368-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 021849 NY Primary

Addresses

Primary practice location

89 Genesee St
Rochester, NY 14611-3201

Mailing address

89 Genesee St
Rochester, NY 14611-3201
Phone (585) 368-3930

Other identifiers 1

IdentifierTypeStateIssuer
01430102MedicaidNY

Other names 1

  • Parkway Apothecary Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Park Ridge Hospitl10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417022526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113201",
            "telephone_number": "585-368-3930",
            "fax_number": "585-368-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113201",
            "telephone_number": "585-368-3930",
            "fax_number": "585-368-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE APOTHECARY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "585-368-3295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "021849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01430102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkway Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.