BB Myrtle Pharmacy Corp

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

029308 Issued in NY

Legal business name

BB MYRTLE PHARMACY CORP

Practice address

141 Charles Ave
Staten Island, NY 10302-1624

Phone

(718) 720-5604

Fax

(718) 770-7687

NPI assigned

Nov 12, 2008

Organization subpart

No

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

Authorized official

Name

Boris Natenzon

Title

Ceo

Phone

(718) 720-3710

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Vitacare Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Recchia, PHARM D

  • Pharmacist
  • Staten Island, NY
  • NPI 1447430996
  NPD
• Arthur Gela

  • Pharmacist
  • Staten Island, NY
  • NPI 1245692540
  NPD (past)

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1497909824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102446",
            "telephone_number": "718-720-3710",
            "fax_number": "718-360-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 CHARLES AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021624",
            "telephone_number": "718-720-5604",
            "fax_number": "718-770-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BB MYRTLE PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "NATENZON",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-720-3710"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "029308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119345",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitacare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vitacare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Bayer, M.A. CCC/SLP
• Ahmed Mohamed Bayoumy, MD
• Baywood LLC
• Evelyn Bazan, LPN
• Mercedes Bazan
• Be a Better You, LLC
• Be Kind to Your Mind Mental Health Counseling, PLLC
• Beach Ny Physical Therapy of Staten Island PLLC
• Denise Beachem
• Beacon Christian Community Health Center

• Long Term Care Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.