Nypres Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034238 Issued in NY

Legal business name

NYPRES PHARMACY INC

Doing business as

NYPRES Pharmacy Inc

Practice address

1083 Saint Nicholas Ave
Sto # 2
New York, NY 10032-3829

Phone

(646) 918-6640

Fax

(646) 918-6803

NPI assigned

Feb 5, 2016

Last updated

Sep 22, 2016By 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

Diana Grullon

Title

President

Phone

(201) 294-9765

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• NYPRES Pharmacy Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

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.

• Diana Grullon Tavares

  • Pharmacist
  • New York, NY
  • NPI 1154862654
  NPD

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1619335593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 SAINT NICHOLAS AVE",
            "address_2": "STO # 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323829",
            "telephone_number": "646-918-6640",
            "fax_number": "646-918-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 SAINT NICHOLAS AVE",
            "address_2": "STO # 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323829",
            "telephone_number": "646-918-6640",
            "fax_number": "646-918-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYPRES PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "GRULLON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-294-9765"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYPRES Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 22, 2016; 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.