M.G.R. Farmacia Latina Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

M.G.R. FARMACIA LATINA INC.

Practice address

3763 103Rd St
Corona, NY 11368-1952

Phone

(718) 205-3633

Fax

(718) 205-5775

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 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

Mr. Rafael Augusto Rodriguez

Title

President

Phone

(718) 205-3633

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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.

• Salah K Ismail, PHARMACIST

  • Pharmacist
  • New York, NY
  • NPI 1033192448
  NPD (past)
• Enis De Jesus Meza-Rodriguez, RPH

  • Pharmacist
  • Corona, NY
  • NPI 1780828541
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528165479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 103RD ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681952",
            "telephone_number": "718-205-3633",
            "fax_number": "718-205-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 103RD ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681952",
            "telephone_number": "718-205-3633",
            "fax_number": "718-205-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.G.R. FARMACIA LATINA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "AUGUSTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-205-3633",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02511122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3336383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Corona, NY
• Providers in Corona, 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 Aug 22, 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.