Organization Active NPI

Achtan Inc

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1609257443
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I046376 Issued in NY
Legal business name
ACHTAN INC
Practice address
759 Burke Ave
Burke Avenue Pharmacy
Bronx, NY 10467-6611
Phone
(347) 326-6000
Fax
(347) 326-6100
NPI assigned
Jun 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Ms. Emerentia EkokobeNPI 1336323682
Title
Pharmacist /Pharmacy Manager
Phone
(347) 326-6000

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 I046376 NY Primary

Addresses

Primary practice location

759 Burke Ave
Burke Avenue Pharmacy
Bronx, NY 10467-6611

Mailing address

759 Burke Ave
Burke Avenue Pharmacy
Bronx, NY 10467-6611
Phone (347) 326-6000

Other names 1

  • Burke Avenue Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151113001082 NY DME Supplier - Pharmacy 4284944695 Practice locations: Bronx, NY
O20170816002885 NY Part B Supplier - Mass Immunization (Roster Biller Only) 4284944695 Practice locations: Bronx, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Burke Avenue Pharmacy759 Burke Avenue, Bronx, NY 10467(347) 326-6000 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Aug 27, 2015

National Provider Directory

National Provider Directory

Locations

759 Burke Ave
Bronx, NY 10467
Phone (347) 326-6000

Practitioners & affiliated clinicians

Practitioners 1

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": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1609257443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 BURKE AVE",
            "address_2": "BURKE AVENUE PHARMACY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676611",
            "telephone_number": "347-326-6000",
            "fax_number": "347-326-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 BURKE AVE",
            "address_2": "BURKE AVENUE PHARMACY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676611",
            "telephone_number": "347-326-6000",
            "fax_number": "347-326-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHTAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "EKOKOBE",
        "authorized_official_first_name": "EMERENTIA",
        "authorized_official_title_or_position": "PHARMACIST /PHARMACY MANAGER",
        "authorized_official_telephone_number": "347-326-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I046376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burke Avenue Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.