Organization Active NPI

Mydesh Inc

Doing business as Monroe Pharmacy

  • Community/Retail Pharmacy
  • Monroe, NY
National Provider Identifier
1518344274
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
033550 Issued in NY
Legal business name
MYDESH INC
Doing business as
Monroe Pharmacy
Practice address
581 Nys Route 17M
Monroe, NY 10950
Phone
(845) 395-0909
NPI assigned
May 1, 2015
Last updated
Dec 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
Mohammed IqbalNPI 1255654646
Title
President & Ceo
Phone
(845) 661-1210

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 033550 NY Primary

Addresses

Primary practice location

581 Nys Route 17M
Monroe, NY 10950

Mailing address

60 Lincoln St
Sloatsburg, NY 10974-1217
Phone (845) 661-1210

Other identifiers 2

IdentifierTypeStateIssuer
04421954MedicaidNY
2151698OtherPK

Other names 1

  • Monroe Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190109001241 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7214228196 Practice locations: Monroe, NY

National Provider Directory

National Provider Directory

Locations

581 State Route 17M
Monroe, NY 10950
Phone (845) 395-0909

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1518344274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LINCOLN ST",
            "city": "SLOATSBURG",
            "state": "NY",
            "postal_code": "109741217",
            "telephone_number": "845-661-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 NYS ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-395-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYDESH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "845-661-1210"
    },
    "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": "033550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04421954",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151698",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.