Montefiore Medical Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

024608 Issued in NY

Legal business name

MONTEFIORE MEDICAL CENTER

Doing business as

Montefiore Community Pharmacy @ Moses

Practice address

111 E 210TH St
FCC Building Ground Floor
Bronx, NY 10467

Phone

(718) 920-7869

Fax

(718) 654-7690

NPI assigned

Feb 28, 2007

Last updated

May 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven W TuckmanNPI 1811011240

Title

Director of Pharmacy

Phone

(718) 920-5194

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Montefiore Community Pharmacy @ Moses Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715

  O20240206002878

  Same enrollment
• Montefiore Medical Center

  dba Montefiore Specialty Pharmacy

  • Community/Retail Pharmacy
  • Yonkers, NY
  • NPI 1659156255

  O20240206002878

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven W Tuckman, RPH

  • Pharmacist
  • Bronx, NY
  • NPI 1811011240
  Authorized official Same address or phone

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1427185057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EAST 210 STREET",
            "address_2": "FCC BUILDING GROUND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-7869",
            "fax_number": "718-654-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "FCC BUILDING GROUND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-7869",
            "fax_number": "718-654-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "TUCKMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "718-920-5194"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NY",
            "license": "024608",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "024608",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "024608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02009598",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "024608",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "3310810",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montefiore Community Pharmacy @ Moses",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center
• Montefiore Medical Center

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.