Sag Harbor Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAG HARBOR PHARMACY INC

Practice address

120 Main St
Sag Harbor, NY 11963-3007

Phone

(631) 725-0072

NPI assigned

Sep 29, 2021

Organization subpart

No

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

Authorized official

Name

Tarique Chaudhary

Title

President

Phone

(631) 899-2526

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1609548650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1050",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119630033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAIN ST",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119633007",
            "telephone_number": "631-725-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAG HARBOR PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "CHAUDHARY",
        "authorized_official_first_name": "TARIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-899-2526"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Antonia Rinaldi, LMHC
• Susan Roman, PT, DPT
• Toni Rozzi
• Ellen Ruby, LCSW, CASAC
• Shirley A Ruch, M.A., CCC-SP
• Sag Harbor Skin and Aesthetics LLC
• Sag Harbor Ufsd
• Sagaponack Medical PC
• Victoria L Sharp, M.D.
• Shene Services LLC

• Community/Retail Pharmacy in Sag Harbor, NY
• Providers in Sag Harbor, 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 29, 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.

Verify at the official NPI Registry.