Organization Active NPI

Five Towns Pharmacy Inc

  • Pharmacist
  • Woodmere, NY
National Provider Identifier
1568515799
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
039031 Issued in NY
Legal business name
FIVE TOWNS PHARMACY INC
Practice address
1019 Broadway
Woodmere, NY 11598-1227
Phone
(516) 374-2930
Fax
(516) 374-0143
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Saud Ansari, BSNPI 1285958181
Title
Owner
Phone
(516) 374-2930

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 039031 NY Primary

Addresses

Primary practice location

1019 Broadway
Woodmere, NY 11598-1227

Mailing address

1019 Broadway
Woodmere, NY 11598
Phone (516) 374-2930

Other identifiers 1

IdentifierTypeStateIssuer
02040191MedicaidNY

National Provider Directory

National Provider Directory

Locations

1019 Broadway
Woodmere, NY 11598
Phone (516) 374-2930

Practitioners & affiliated clinicians

Practitioners 2

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1568515799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "11598",
            "telephone_number": "516-374-2930",
            "fax_number": "516-374-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981227",
            "telephone_number": "516-374-2930",
            "fax_number": "516-374-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE TOWNS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "ANSARI",
        "authorized_official_first_name": "SAUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-374-2930",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "039031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02040191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.