Active NPI
Tompkinsville RX Inc
Doing business as Tompkinsville Pharmacy
- Community/Retail Pharmacy
- Staten Island, NY
National Provider Identifier
1588124101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- 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, 2021
- 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. Nehal Patel
- Title
- Vice-President
- Phone
- (718) 727-0430
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Tompkinsville Pharmacy - LTC
- Long Term Care Pharmacy
- Staten Island, NY
- NPI 1023801156
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.