Edelsie Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032282 Issued in NY

Legal business name

EDELSIE PHARMACY INC

Practice address

11228 Francis Lewis Blvd
Queens Village, NY 11429-2224

Phone

(718) 736-0036

Fax

(718) 736-0034

NPI assigned

Nov 15, 2013

Organization subpart

No

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

Authorized official

Name

Edris VincentNPI 1356664288

Title

RPH Supervising Pharmacist

Phone

(917) 216-2630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edelsie Pharmacy Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Edris Vincent, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1356664288
  NPD Authorized official
• Jean Ding, B.S. PHARM., RPH

  • Pharmacist
  • Fresh Meadows, NY
  • NPI 1053633222
  NPD (past)

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1538599303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11228 FRANCIS LEWIS BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292224",
            "telephone_number": "718-736-0036",
            "fax_number": "718-736-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11228 FRANCIS LEWIS BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292224",
            "telephone_number": "718-736-0036",
            "fax_number": "718-736-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDELSIE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "EDRIS",
        "authorized_official_title_or_position": "RPH SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "917-216-2630"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edelsie Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Bamigwojor Ebeh
• Ebenezer Odoom MD PC
• Ebi Pharmacy & Supermarket Inc
• Justina Ebinum
• Ruby C Echevarre
• Magdie Edouard
• Marie Jude Edouard
• Annette Edwards, LPN
• Michael P. Ehrenhaus, M.D.
• Elie J. Sarkis, MD, PC

• Community/Retail Pharmacy in Queens Village, NY
• Providers in Queens Village, 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 Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.