Organization Active NPI

Lerds Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1508898834
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
027800 Issued in NY
Legal business name
LERDS PHARMACY INC
Doing business as
Lerds Pharmacy Inc
Practice address
1601 Gravesend Neck Rd
Brooklyn, NY 11229-4426
Phone
(718) 332-5330
Fax
(718) 332-5880
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Renata Gligich, PHARMACISTNPI 1578711826
Title
Owner Pic
Phone
(718) 332-5330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 027800 NY Primary

Addresses

Primary practice location

1601 Gravesend Neck Rd
Brooklyn, NY 11229-4426

Mailing address

1601 Gravesend Neck Rd
Brooklyn, NY 11229-4426
Phone (718) 332-5330

Other identifiers 2

IdentifierTypeStateIssuer
02760245MedicaidNY
2068102OtherPK

Other names 1

  • LERDS PHARMACY INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930029214 NY DME Supplier - Pharmacy 3971706409 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Lerds Pharmacy Inc2 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.

Locations

1601 Gravesend Neck Rd
Fl 1
Brooklyn, NY 11229
Phone (718) 332-5330

1601 Gravesend Neck Rd
Brooklyn, NY 11229
Phone (718) 332-5330

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1508898834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294426",
            "telephone_number": "718-332-5330",
            "fax_number": "718-332-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294426",
            "telephone_number": "718-332-5330",
            "fax_number": "718-332-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LERDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "GLIGICH",
        "authorized_official_first_name": "RENATA",
        "authorized_official_title_or_position": "OWNER PIC",
        "authorized_official_telephone_number": "718-332-5330",
        "authorized_official_credential": "PHARMACIST"
    },
    "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": "027800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02760245",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068102",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LERDS PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.