Pharmacy 112 Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

032401 Issued in NY

Legal business name

PHARMACY 112 INC.

Practice address

2608 Route 112 # B
Medford, NY 11763-2551

Phone

(631) 438-0530

NPI assigned

Dec 18, 2013

Last updated

Oct 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Koller

Title

Coo

Phone

(631) 475-4141

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Country Chemists Inc

  dba Hunold Pharmacy

  • Community/Retail Pharmacy
  • Port Washington, NY
  • NPI 1700968591

  Member Of

  NPD member
• Good Buy Drug LLC

  dba Beacon Pharmacy

  • Community/Retail Pharmacy
  • Port Washington, NY
  • NPI 1518049303

  Member Of

  NPD member
• Medford Chemists Inc.

  • Long Term Care Pharmacy
  • Medford, NY
  • NPI 1477586832

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1598186595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 ROUTE 112",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 ROUTE 112 # B",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632551",
            "telephone_number": "631-438-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY 112 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "KOLLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "631-475-4141"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "032401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598186595",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRATION",
            "identifier": "032401",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriana Perez
• David William Perkins, LCSW
• Frank C Perry, DDS
• Stephanie Persico, LCSW
• Yewande Olukemi Peters, RN
• Zoraya Pichardo, RPH
• Teresa Picon
• Nanotte Pierre-Louis
• Richard Jay Pitch, MD
• Platinum Home Management LLC

• Pharmacy in Medford, NY
• Providers in Medford, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.