Bartles Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Oxford, NY
NPI 1497842363 · NPPES record last updated Jan 31, 2018
Key facts
- NPI
- 1497842363
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 013652 (NY)
- Legal business name
- BARTLES PHARMACY INC
- Practice address
- 10 Lafayette Park
Oxford, NY 13830-0630 - Phone
- (607) 843-2841
- Fax
- (607) 843-6874
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Brian Bartle, PHARMD
- Title
- Pres
- Phone
- (607) 843-2841
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090929000494 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981740271 |
1 other NPI on this enrollment Practice locations: Oxford, NY |
| O20201218001107 | NY | Part B Supplier - Independent Clinical Laboratory | 4981740271 | Practice locations: Oxford, NY |
| O20240513000163 | NY | Part B Supplier - Pharmacy | 4981740271 | Practice locations: Oxford, NY |
National Provider Directory
- Tax ID family
- Bartles Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 013652 | NY | Yes |
Addresses
Primary practice location
10 Lafayette Park
Oxford, NY 13830-0630
Mailing address
PO Box 630
Oxford, NY 13830-0630
Phone (607) 843-2841
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2063388 | Other | PK | |
| 00451487 | Medicaid | NY |
Other providers in Oxford, NY
- Jackie Lynn Barrows
- Paula Renee Barrows
- Brian W Bartle
- Bartles Pharmacy Inc
- Bartles Pharmacy Inc
- Donna Cipriano Brady
- Maryann Champlin
- Audrey Clinton
- Kimberly Martin Cole
- David James Crugnale
All providers in Oxford, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.