139 Center Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

033068 Issued in NY

Legal business name

139 CENTER PHARMACY, LLC

Practice address

139 Centre St
Store 105
New York, NY 10013-4552

Phone

(646) 838-6388

Fax

(718) 513-2047

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Tristan Liu

Title

Corporate Officer

Phone

(646) 801-4876

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1609278308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST",
            "address_2": "STORE 105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134552",
            "telephone_number": "646-838-6388",
            "fax_number": "718-513-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST",
            "address_2": "STORE 105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134552",
            "telephone_number": "646-838-6388",
            "fax_number": "718-513-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "139 CENTER PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "646-801-4876"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "033068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 133 East Medical PC
• 133Rd Street Pharmacy Inc
• 135 Medical PC
• 137 Mott Pharmacy, Inc.
• 137 Pharmacy Corp.
• 139 Medical Facility P C
• 139 Medical P.C.
• 139 Pharmacy, Inc.
• 13TH Street Optical, LLC
• 14 Street Medical, PC

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.