Medwiz Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

029312 Issued in NY

Legal business name

MEDWIZ PHARMACY LLC

Doing business as

MedWiz Pharmacy, LLC

Practice address

240 N Main St
Spring Valley, NY 10977-4020

Phone

(845) 624-5200

Fax

(845) 624-5300

NPI assigned

Aug 12, 2015

Organization subpart

No

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

Authorized official

Name

Eric Newhouse

Title

Ceo,Owner,Ao

Phone

(845) 558-5390

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MedWiz Pharmacy, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Medwiz Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medwiz Pharmacy LLC

  • Long Term Care Pharmacy
  • Spring Valley, NY
  • NPI 1093239337
  NPD tax ID

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1477929529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N MAIN ST",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774020",
            "telephone_number": "845-624-5200",
            "fax_number": "845-624-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N MAIN ST",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774020",
            "telephone_number": "845-624-5200",
            "fax_number": "845-624-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWIZ PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "NEWHOUSE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO,OWNER,AO",
        "authorized_official_telephone_number": "845-558-5390"
    },
    "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": "029312",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04418659",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153610",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedWiz Pharmacy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Spring Valley, NY
• Providers in Spring Valley, 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 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.