Bobs Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BOBS PHARMACY LLC

Practice address

430 Bleecker St
Utica, NY 13501

Phone

(315) 732-6915

Fax

(315) 732-6641

NPI assigned

Sep 4, 2018

Last updated

Mar 13, 2020By 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

Sarath Adusumalli

Title

Owner

Phone

(315) 732-6915

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Bobs 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.

• Bobs Pharmacy LLC

  • Long Term Care Pharmacy
  • Utica, NY
  • NPI 1225871767
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Amazing Community Pharmacy LLC

  dba Amazing Pharmacy

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1114460235

  Member Of

  NPD member
• Sai RX Mart LLC

  • Community/Retail Pharmacy
  • Staten Island, NY
  • NPI 1609327113

  Member Of

  NPD member

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.

• Sarathchandra Adusumalli

  • Pharmacist
  • Brooklyn, NY
  • NPI 1639461759
  NPD
• Giridhar V Athmakuri, PHARMACIST

  • Pharmacist
  • Utica, NY
  • NPI 1023340676
  NPD

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1497237622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13501",
            "telephone_number": "315-732-6915",
            "fax_number": "315-732-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13501",
            "telephone_number": "315-732-6915",
            "fax_number": "315-732-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "ADUSUMALLI",
        "authorized_official_first_name": "SARATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-732-6915"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Blatt, M.D.
• Dennis Blom, MD
• Bloom Nutrition Solutions LLC
• Jaime Michelle Blum, FNP
• Bobs Pharmacy LLC
• Bodywise Pure Pilates, LLC (Bodywise)
• Deanna Boehlert
• Frank Harrison Boehm Jr., M.D.
• Patrice Anne Bogan, N.P.
• Jaclyn Marie Bogdan

• Community/Retail Pharmacy in Utica, NY
• Providers in Utica, 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 Mar 13, 2020; 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.