NPIMap

Organization Active NPI

Wakefield Pharmacy Inc.

  • Pharmacist
  • South Ozone Park, NY
National Provider Identifier
1619195898
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30920 Issued in NY
Legal business name
WAKEFIELD PHARMACY INC.
Practice address
13525 Lefferts Blvd
South Ozone Park, NY 11420-3601
Phone
(718) 843-3900
Fax
(718) 843-6044
NPI assigned
Apr 23, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Robert Thomas Mason, RPH-BS-MS-PHARMDNPI 1013230531
Title
Pharmacist
Phone
(718) 843-3900

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
Pharmacist 183500000X 30920 NY Primary

Addresses

Primary practice location

13525 Lefferts Blvd
South Ozone Park, NY 11420-3601

Mailing address

13525 Lefferts Blvd
South Ozone Park, NY 11420-3601
Phone (718) 843-3900

Other identifiers 2

IdentifierTypeStateIssuer
3375816OtherNYNAPB NUMBER
017693OtherNYSTORE STATE LICENSE NO.

Other names 1

  • Queens Wakefield Pharmacy Other name

National Provider Directory

National Provider Directory

Locations

13525 Lefferts Blvd
South Ozone Park, NY 11420
Phone (718) 843-3900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1619195898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 LEFFERTS BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203601",
            "telephone_number": "718-843-3900",
            "fax_number": "718-843-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 LEFFERTS BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203601",
            "telephone_number": "718-843-3900",
            "fax_number": "718-843-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFIELD PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-843-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH-BS-MS-PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "30920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB NUMBER",
            "identifier": "3375816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STORE STATE LICENSE NO.",
            "identifier": "017693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queens Wakefield Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.