Organization Active NPI

Sutphin RX Inc

  • Community/Retail Pharmacy
  • Jamaica, NY
National Provider Identifier
1609637511
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SUTPHIN RX INC
Practice address
11315 Sutphin Blvd
Jamaica, NY 11435-5832
Phone
(718) 480-1016
Fax
(718) 480-1017
NPI assigned
Jan 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Mohamad CheaitoNPI 1336665157
Title
Owner/SP
Phone
(718) 480-1016

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
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

11315 Sutphin Blvd
Jamaica, NY 11435-5832

Mailing address

11315 Sutphin Blvd
Jamaica, NY 11435-5832
Phone (718) 480-1016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250103001517 NY DME Supplier - Pharmacy 2264871078 Practice locations: Jamaica, NY

National Provider Directory

National Provider Directory

Locations

11315 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 480-1016

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": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1609637511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355832",
            "telephone_number": "718-480-1016",
            "fax_number": "718-480-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355832",
            "telephone_number": "718-480-1016",
            "fax_number": "718-480-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTPHIN RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "CHEAITO",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_title_or_position": "OWNER/SP",
        "authorized_official_telephone_number": "718-480-1016"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.