Active NPI
RND Pharmacy Inc
Doing business as Casa de Vida Pharmacy
- Community/Retail Pharmacy
- Bronx, NY
National Provider Identifier
1417197492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 031470
- Legal business name
- RND PHARMACY INC
- Doing business as
- Casa de Vida Pharmacy
- Practice address
- 52 W Burnside Ave
Bronx, NY 10453-4018 - Phone
- (347) 820-7989
- Fax
- (347) 820-7990
- NPI assigned
- Mar 3, 2009
- 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
- Mayur Pandya
- Title
- Supervising Pharmacist
- Phone
- (347) 820-7989
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 031470 | NY | Primary |
Addresses
Primary practice location
52 W Burnside Ave
Bronx, NY 10453-4018
Mailing address
52 W Burnside Ave
Bronx, NY 10453-4018
Phone (347) 820-7989
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2137094 | Other | PK | |
| 03446788 | Medicaid | NY |
Other names 1
- CASA DE VIDA PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130208000028 | NY | DME Supplier - Pharmacy | 1052565587 | Practice locations: Bronx, NY |
| O20210128001689 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 1052565587 | Practice locations: Bronx, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Casa de Vida Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
52 W Burnside Ave
Bronx, NY 10453
Phone (347) 820-7989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236038400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531958400000",
"number": "1417197492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 W BURNSIDE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534018",
"telephone_number": "347-820-7989",
"fax_number": "347-820-7990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 W BURNSIDE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534018",
"telephone_number": "347-820-7989",
"fax_number": "347-820-7990"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RND PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-03",
"last_updated": "2018-07-19",
"status": "A",
"authorized_official_last_name": "PANDYA",
"authorized_official_first_name": "MAYUR",
"authorized_official_title_or_position": "SUPERVISING PHARMACIST",
"authorized_official_telephone_number": "347-820-7989"
},
"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": "031470",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2137094",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03446788",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CASA DE VIDA PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.