Active NPI
Super Health Pharmacy LLC
- Long Term Care Pharmacy
- Staten Island, NY
National Provider Identifier
1588239552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- SUPER HEALTH PHARMACY LLC
- Practice address
- 6390 Amboy Rd
Staten Island, NY 10309-3155 - Phone
- (718) 967-4600
- Fax
- (718) 967-4601
- NPI assigned
- May 23, 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
- Dr. Mayank Parikh
- Title
- President
- Phone
- (718) 967-4600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
6390 Amboy Rd
Staten Island, NY 10309-3155
Mailing address
6390 Amboy Rd
Staten Island, NY 10309-3155
Phone (718) 967-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04714256 | Medicaid | NY |
Other names 1
- Super Health Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Super Health Pharmacy LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Health Educator
- Staten Island, NY
- NPI 1447008453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622160000000",
"number": "1588239552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6390 AMBOY RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103093155",
"telephone_number": "718-967-4600",
"fax_number": "718-967-4601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6390 AMBOY RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103093155",
"telephone_number": "718-967-4600",
"fax_number": "718-967-4601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPER HEALTH PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-23",
"last_updated": "2021-05-28",
"certification_date": "2021-05-28",
"status": "A",
"authorized_official_last_name": "PARIKH",
"authorized_official_first_name": "MAYANK",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-967-4600",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04714256",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Super Health Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Super Health 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 May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.