Pharmacy Depot LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030569 Issued in NY

Legal business name

PHARMACY DEPOT LLC

Doing business as

pharmacy depot llc

Practice address

317 Brighton Beach Ave
Brooklyn, NY 11235-7412

Phone

(718) 646-0001

NPI assigned

Apr 11, 2011

Last updated

Jul 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dina Shifgert

Title

Supervising Pharmacist

Phone

(718) 646-0001

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• pharmacy depot llc Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Pharmacy Depot LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pharmacy Depot LLC

  • Pharmacy
  • Brooklyn, NY
  • NPI 1609167196
  NPD tax ID

Practitioners 2

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.

• Natalia G Fateeva

  • Pharmacist
  • Brooklyn, NY
  • NPI 1356635783
  NPD (past)
• Michael A Lerner, M.D.

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1508849308
  NPD (past)

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1619267747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 BRIGHTON BEACH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357412",
            "telephone_number": "718-646-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BRIGHTON BEACH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357412",
            "telephone_number": "718-646-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY DEPOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "SHIFGERT",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-646-0001"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5802334",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pharmacy depot llc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "pharmacy depot llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 Jul 1, 2019; 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.