Organization Active NPI

Community Pharmacy Inc

  • Community/Retail Pharmacy
  • Brewster, NY
National Provider Identifier
1629155361
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
019063 Issued in NY
Legal business name
COMMUNITY PHARMACY INC
Practice address
100 Independent Way
Ste G
Brewster, NY 10509-6301
Phone
(845) 278-2700
Fax
(845) 278-7339
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Gina Cornacchio, RPHNPI 1598097677
Title
Supervising Pharmacist
Phone
(845) 278-2700

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 019063 NY Primary

Addresses

Primary practice location

100 Independent Way
Ste G
Brewster, NY 10509-6301

Mailing address

100 Independent Way
Ste G
Brewster, NY 10509-6301
Phone (845) 278-2700

Other identifiers 2

IdentifierTypeStateIssuer
2064381OtherPK
00754590MedicaidNY

Other names 1

  • COMMUNITY 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
O20100930053212 NY DME Supplier - Pharmacy 6507912516 Practice locations: Brewster, NY
O20191015001650 NY Part B Supplier - Pharmacy 6507912516 Practice locations: Brewster, 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
Community Pharmacy Inc100 Independent Way, Brewster, NY 10509-6303(845) 278-2700 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Aug 18, 2009

National Provider Directory

National Provider Directory

Locations

100 Independent Way
Ste G
Brewster, NY 10509
Phone (845) 278-2700

Practitioners & affiliated clinicians

Practitioners 3

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1629155361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENT WAY",
            "address_2": "STE G",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105096301",
            "telephone_number": "845-278-2700",
            "fax_number": "845-278-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENT WAY",
            "address_2": "STE G",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105096301",
            "telephone_number": "845-278-2700",
            "fax_number": "845-278-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "CORNACCHIO",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "845-278-2700",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "019063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064381",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00754590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.