Active NPI
Sugarless Shoppe, Inc.
- Durable Medical Equipment & Medical Supplies
- Farmingdale, NY
National Provider Identifier
1457413155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01613083 | Medicaid | NY |
Other names 1
- Sugar Control Center
National Provider Directory
National Provider DirectoryLocations
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.
-
- Diabetes Educator Registered Nurse
- Farmingdale, NY
- NPI 1194889741
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.