Organization Active NPI

Atj Enterprise Inc.

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1629785845
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ATJ ENTERPRISE INC.
Doing business as
Roseview Pharmacy
Practice address
1077 Bay St Ste 6
Staten Island, NY 10305-4918
Phone
(718) 885-4260
Fax
(845) 648-3411
NPI assigned
Oct 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Authorized official

Name
Kok Timmy Lang, PHARM.D
Title
Owner
Phone
(347) 893-4227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1077 Bay St Ste 6
Staten Island, NY 10305-4918

Mailing address

93 Lynhurst Ave
Staten Island, NY 10305-1808
Phone (347) 893-4227

Other identifiers 1

IdentifierTypeStateIssuer
039876OtherNYSTATE BOARD OF PHARMACY

Other names 1

  • Roseview 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
O20230403000937 NY Part B Supplier - Pharmacy 6608241799 Practice locations: Staten Island, NY
O20230523002811 NY DME Supplier - Pharmacy 6608241799 Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Tax ID family
Atj Enterprise Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1077 Bay St
Ste 6
Staten Island, NY 10305
Phone (718) 885-4260

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": "1666915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1629785845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 LYNHURST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051808",
            "telephone_number": "347-893-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 BAY ST STE 6",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054918",
            "telephone_number": "718-885-4260",
            "fax_number": "845-648-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATJ ENTERPRISE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "KOK TIMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-893-4227",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "039876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roseview Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.