Organization Active NPI

Sos Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1619312279
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SOS PHARMACY INC
Practice address
1201 Avenue Z
Brooklyn, NY 11235-4301
Phone
(917) 933-4000
Fax
(917) 933-4004
NPI assigned
May 8, 2013
Last updated
Feb 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Authorized official

Name
Mrs. Shushana Semenov
Title
President
Phone
(917) 933-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1201 Avenue Z
Brooklyn, NY 11235-4301

Mailing address

1201 Avenue Z
Brooklyn, NY 11235-4301
Phone (917) 933-4000

Other identifiers 4

IdentifierTypeStateIssuer
03633823MedicaidNY
032055OtherNYNY STATE LICENSE
5808211OtherNYNCPDP
6979960001OtherNYMEDICARE NSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140130000165 NY DME Supplier - Pharmacy 0143459818 Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Sos Pharmacy Inc1201 Avenue Z, Brooklyn, NY 11235-4301(917) 933-4000 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Nebulizer Equipment and/or Supplies Does not accept assignmentParticipating since Jan 17, 2014

National Provider Directory

National Provider Directory

Locations

1201 Avenue Z
Brooklyn, NY 11235
Phone (917) 933-4000

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": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1619312279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354301",
            "telephone_number": "917-933-4000",
            "fax_number": "917-933-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354301",
            "telephone_number": "917-933-4000",
            "fax_number": "917-933-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "SEMENOV",
        "authorized_official_first_name": "SHUSHANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-933-4000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03633823",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "032055",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5808211",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "6979960001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.