Organization Active NPI

Sugarless Shoppe, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Farmingdale, NY
National Provider Identifier
1457413155
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUGARLESS SHOPPE, INC.
Practice address
306 Main St
Farmingdale, NY 11735-3507
Phone
(631) 773-5370
Fax
(631) 773-5369
NPI assigned
Dec 16, 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. Ira William Small, DME
Title
Vice President
Phone
(631) 773-5370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

306 Main St
Farmingdale, NY 11735-3507

Mailing address

306 Main St
Farmingdale, NY 11735-3507
Phone (631) 773-5370

Other identifiers 1

IdentifierTypeStateIssuer
01613083MedicaidNY

Other names 1

  • Sugar Control Center Doing business as

National Provider Directory

National Provider Directory

Locations

306 Main St
Farmingdale, NY 11735
Phone (631) 773-5370

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457413155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353507",
            "telephone_number": "631-773-5370",
            "fax_number": "631-773-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353507",
            "telephone_number": "631-773-5370",
            "fax_number": "631-773-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARLESS SHOPPE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "631-773-5370",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DME"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01613083",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sugar Control Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmingdale, 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.