Active NPI
Abc Pharmacy V Corp.
Doing business as abc pharmacy
- Community/Retail Pharmacy
- New York, NY
National Provider Identifier
1528362811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 030509
- Legal business name
- ABC PHARMACY V CORP.
- Doing business as
- abc pharmacy
- Practice address
- 17 E Broadway Store #105
New York, NY 10002-6994 - Phone
- (212) 965-8882
- Fax
- (212) 965-8278
- NPI assigned
- Jan 1, 2011
- Last updated
- Jan 24, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Hok Doon John Au
- Title
- President
- Phone
- (347) 680-6278
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 030509 | NY | |
| Community/Retail Pharmacy | 3336C0003X | 030509 | NY | Primary |
Addresses
Primary practice location
17 E Broadway Store #105
New York, NY 10002-6994
Mailing address
17 E Broadway Store #105
New York, NY 10002-6994
Phone (212) 965-8882
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5801938 | Other | NY | NCDBP |
Other names 1
- abc pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110408000253 | NY | DME Supplier - Pharmacy | 1355525726 | Practice locations: New York, NY |
| O20230405001653 | NY | Part B Supplier - Pharmacy | 1355525726 | Practice locations: New York, NY |
National Provider Directory
National Provider DirectoryLocations
17 E Broadway
#105
New York, NY 10002
Phone (212) 965-8882
17 E Broadway
Unit 105
New York, NY 10002
Phone (212) 965-8885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1485216000000",
"number": "1528362811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 E BROADWAY STORE #105",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100026994",
"telephone_number": "212-965-8882",
"fax_number": "212-965-8278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 E BROADWAY STORE #105",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100026994",
"telephone_number": "212-965-8882",
"fax_number": "212-965-8278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ABC PHARMACY V CORP.",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-01",
"last_updated": "2017-01-24",
"status": "A",
"authorized_official_last_name": "AU",
"authorized_official_first_name": "HOK DOON JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "347-680-6278",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NY",
"license": "030509",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "030509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCDBP",
"identifier": "5801938",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "abc pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.