Organization Active NPI

Watsons Pharmacy, LLC

  • Community/Retail Pharmacy
  • Flushing, NY
National Provider Identifier
1548485444
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WATSONS PHARMACY, LLC
Practice address
4243 Main St
Flushing, NY 11355-4721
Phone
(718) 359-1188
Fax
(718) 359-1187
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Authorized official

Name
Jerry Louie
Title
Owner
Phone
(718) 359-1188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4243 Main St
Flushing, NY 11355-4721

Mailing address

4243 Main St
Flushing, NY 11355-4721
Phone (718) 359-1188

Other identifiers 1

IdentifierTypeStateIssuer
02932314MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220513000321 NY Part B Supplier - Pharmacy 3274739842 Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

19221 Station Rd
Flushing, NY 11358
Phone (347) 732-9724

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1548485444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554721",
            "telephone_number": "718-359-1188",
            "fax_number": "718-359-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554721",
            "telephone_number": "718-359-1188",
            "fax_number": "718-359-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATSONS PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "LOUIE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-359-1188"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02932314",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.