Interstate Pharmaceutical Services

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

019407 Issued in NY

Legal business name

INTERSTATE PHARMACEUTICAL SERVICES

Doing business as

Spectrum Pharmacy

Practice address

952 McDonald Ave
Brooklyn, NY 11218-5612

Phone

(718) 435-3100

Fax

(718) 435-1671

NPI assigned

Jan 30, 2007

Last updated

Sep 22, 2016By 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

Arthur KonigNPI 1225360332

Title

SP

Phone

(718) 435-3100

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SPECTRUM PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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.

• Arthur Konig, R.PH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1225360332
  NPD Authorized official
• Doron Evans, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1649502790
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1457497067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185612",
            "telephone_number": "718-435-3100",
            "fax_number": "718-435-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185612",
            "telephone_number": "718-435-3100",
            "fax_number": "718-435-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE PHARMACEUTICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "KONIG",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "SP",
        "authorized_official_telephone_number": "718-435-3100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "019407",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01018726",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.