Organization Active NPI

Mela Pharmacy LLC

  • Pharmacy
  • South Richmond Hill, NY
National Provider Identifier
1619667615
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MELA PHARMACY LLC
Practice address
11003 101St Avenue
South Richmond Hill, NY 11419-1031
Phone
(718) 674-6161
Fax
(718) 674-6464
NPI assigned
May 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Authorized official

Name
Versha Dodwani Lohana
Title
President
Phone
(718) 674-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

11003 101St Avenue
South Richmond Hill, NY 11419-1031

Mailing address

11003 101St Avenue
South Richmond Hill, NY 11419
Phone (718) 674-6161

Other names 1

  • Mela Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230720000729 NY Part B Supplier - Pharmacy 9436519550 Practice locations: South Richmond Hill, NY
O20240315001899 NY DME Supplier - Pharmacy 9436519550 Practice locations: South Richmond Hill, NY

National Provider Directory

National Provider Directory

Locations

11003 101st Ave
South Richmond Hill, NY 11419
Phone (718) 674-6161

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": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1619667615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11003 101ST AVENUE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "11419",
            "telephone_number": "718-674-6161",
            "fax_number": "718-674-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11003 101ST AVENUE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191031",
            "telephone_number": "718-674-6161",
            "fax_number": "718-674-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "LOHANA",
        "authorized_official_first_name": "VERSHA",
        "authorized_official_middle_name": "DODWANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-674-6161"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mela Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mela Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.