Active NPI
Mela Pharmacy LLC
- Pharmacy
- South Richmond Hill, NY
National Provider Identifier
1619667615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Pharmacist
- South Richmond Hill, NY
- NPI 1013794973
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.