Active NPI
Shimons Pharmacy Inc
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1629147012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 024761
- Legal business name
- SHIMONS PHARMACY INC
- Practice address
- 115 Lee Ave
Brooklyn, NY 11211-7904 - Phone
- (718) 384-0234
- Fax
- (718) 384-3910
- NPI assigned
- Nov 7, 2006
- 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
- Mr. Ersel Kohanteb
- Title
- President
- Phone
- (718) 384-0234
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 024761 | NY | Primary |
Addresses
Primary practice location
115 Lee Ave
Brooklyn, NY 11211-7904
Mailing address
115 Lee Ave
Brooklyn, NY 11211-7904
Phone (718) 384-0234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220912000721 | NY | Part B Supplier - Pharmacy | 7911242581 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Brooklyn, NY
- NPI 1508148446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660003200000",
"number": "1629147012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 LEE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112117904",
"telephone_number": "718-384-0234",
"fax_number": "718-384-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 LEE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112117904",
"telephone_number": "718-384-0234",
"fax_number": "718-384-3910"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHIMONS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-07",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A",
"authorized_official_last_name": "KOHANTEB",
"authorized_official_first_name": "ERSEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-384-0234",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "024761",
"primary": true
}
],
"identifiers": [],
"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 Aug 9, 2022; 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.