Pharmacade Pharmacy Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

014782 Issued in NY

Legal business name

PHARMACADE PHARMACY INC

Practice address

1049 E 163Rd St
Bronx, NY 10459-4510

Phone

(718) 842-5485

Fax

(718) 842-8435

NPI assigned

Oct 24, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Maurice Malin, RPH

Title

Pres

Phone

(718) 842-5485

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1477543189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 E 163RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104594510",
            "telephone_number": "718-842-5485",
            "fax_number": "718-842-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 E 163RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104594510",
            "telephone_number": "718-842-5485",
            "fax_number": "718-842-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACADE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "MALIN",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "718-842-5485",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "014782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01240651",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim N Pham, PA-C
• Phuong Pham
• Yolanda Pham, MD, MPH
• Cuong Anh Phan, DPM
• Paulette Phanord, REGISTERED NURSE
• Pharmacia Lacross Inc
• Pharmacy Plus Surgical Supplies Inc
• Pharmart Drugs Inc
• Pharmavida RX LLC
• Pharmblue Ny LLC

• Durable Medical Equipment & Medical Supplies in Bronx, NY
• Providers in Bronx, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.