NPIMap

Organization Active NPI

Washingtonville Pharmacy Inc

  • Long Term Care Pharmacy
  • Washingtonville, NY
National Provider Identifier
1629794532
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
WASHINGTONVILLE PHARMACY INC
Practice address
32 W Main St Unit 2
Washingtonville, NY 10992-1411
Phone
(845) 496-8001
Fax
(845) 496-8005
NPI assigned
Oct 13, 2022
Organization subpart
Yes
Parent organization
WASHINGTONVILLE PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Mark Patrick FreitasNPI 1558490235
Title
President
Phone
(845) 496-8001

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

32 W Main St Unit 2
Washingtonville, NY 10992-1411

Mailing address

32 W Main St Unit 2
Washingtonville, NY 10992-1411
Phone (845) 496-8001

Other identifiers 1

IdentifierTypeStateIssuer
02891303MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Washingtonville Pharmacy Inc2 organizations share this tax ID, including this one
Part of
Washingtonville Pharmacy Inc

Other organizations with this tax ID 1

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

Locations

32 W Main St
Ste 2
Washingtonvle, NY 10992
Phone (845) 496-8001

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1629794532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 W MAIN ST UNIT 2",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109921411",
            "telephone_number": "845-496-8001",
            "fax_number": "845-496-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 W MAIN ST UNIT 2",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109921411",
            "telephone_number": "845-496-8001",
            "fax_number": "845-496-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTONVILLE PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTONVILLE PHARMACY INC",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "FREITAS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-496-8001"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02891303",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washingtonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.