King Kullen Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

023307 Issued in NY

Legal business name

KING KULLEN PHARMACY

Practice address

120 Veterans Memorial Hwy
Commack, NY 11725-3432

Phone

(631) 864-3085

Fax

(631) 864-3085

NPI assigned

Jan 8, 2007

Organization subpart

Yes

Parent organization

KING KULLEN GROCERY CO. INC.As reported in NPPES

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

Authorized official

Name

Albert Hesse, RPH

Title

Pharmacy Coordinator

Phone

(516) 733-7100

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Thomas John Rossi, RPH

  • Pharmacist
  • Commack, NY
  • NPI 1134390362
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1447308408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KING KULLEN GROCERY CO INC",
            "address_2": "185 CENTRAL AVE DEPT 1030",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143929",
            "telephone_number": "516-733-7100",
            "fax_number": "516-827-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253432",
            "telephone_number": "631-864-3085",
            "fax_number": "631-864-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING KULLEN PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING KULLEN GROCERY CO. INC.",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "HESSE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "516-733-7100",
        "authorized_official_credential": "RPH"
    },
    "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": "023307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3331775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3331775",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01787966",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert E. Kifer, PH.D.
• Eileen Kilgus-Reid, MS, RN, FNP-BC
• Ju Seok Kim
• Soohyun Kim
• Tae Yon Kim, D.D.S.
• Rebecca Kissinger
• Jason Adam Klein, M.D.
• Staci Kleinberg
• Audrone Liucija Klimas, M.A.
• Veronica Klimek, CASAC-T

• Community/Retail Pharmacy in Commack, NY
• Providers in Commack, 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 Feb 24, 2009; 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.