Organization Active NPI

Tompkinsville RX Inc

Doing business as Tompkinsville Pharmacy

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1588124101
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TOMPKINSVILLE RX INC
Doing business as
Tompkinsville Pharmacy
Practice address
45 Victory Blvd
Staten Island, NY 10301-2937
Phone
(718) 727-0430
Fax
(718) 727-0667
NPI assigned
Mar 20, 2019
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Mr. Nehal Patel
Title
Vice-President
Phone
(718) 727-0430

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

45 Victory Blvd
Staten Island, NY 10301-2937

Mailing address

45 Victory Blvd
Staten Island, NY 10301-2937
Phone (718) 727-0430

Other names 1

  • TOMPKINSVILLE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20190715002076 NY DME Supplier - Pharmacy 0547595415 Practice locations: Staten Island, NY
O20211029001921 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0547595415 Practice locations: Staten Island, NY
O20220416000129 NY Part B Supplier - Pharmacy 0547595415 Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Tax ID family
Tompkinsville Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1588124101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012937",
            "telephone_number": "718-727-0430",
            "fax_number": "718-727-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012937",
            "telephone_number": "718-727-0430",
            "fax_number": "718-727-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMPKINSVILLE RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "NEHAL",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "718-727-0430",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOMPKINSVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.