Organization Active NPI

Evans Drug Store,Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1639211790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
023657 Issued in NY
Legal business name
EVANS DRUG STORE,INC
Practice address
878 Nostrand Avenue
Brooklyn, NY 11225
Phone
(718) 771-7271
Fax
(718) 953-5626
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Roberta Greenfeld
Title
President
Phone
(718) 771-7271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 023657 NY Primary

Addresses

Primary practice location

878 Nostrand Avenue
Brooklyn, NY 11225

Mailing address

878 Nostrand Ave
Brooklyn, NY 11225-2226
Phone (718) 771-7271

Other identifiers 1

IdentifierTypeStateIssuer
01825561MedicaidNY

National Provider Directory

National Provider Directory

Locations

878 Nostrand Ave
Brooklyn, NY 11225
Phone (718) 771-7271

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639211790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112252226",
            "telephone_number": "718-771-7271",
            "fax_number": "718-953-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 NOSTRAND AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11225",
            "telephone_number": "718-771-7271",
            "fax_number": "718-953-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DRUG STORE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENFELD",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-771-7271",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "023657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01825561",
            "state": "NY"
        }
    ],
    "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 22, 2020; 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.