NPIMap

Organization Active NPI

Rex Specialty Pharmacy Corp

  • Pharmacy
  • Valley Stream, NY
National Provider Identifier
1649415704
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
REX SPECIALTY PHARMACY CORP
Practice address
48 Central CT
Valley Stream, NY 11580-1143
Phone
(516) 593-7747
Fax
(516) 593-7094
NPI assigned
Dec 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Dr. Ali Hassan Jaffery, PHARM.DNPI 1093062812
Title
President/Supervising Pharmacist
Phone
(516) 593-7747

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 Primary
Community/Retail Pharmacy 3336C0003X 029168 NY

Addresses

Primary practice location

48 Central CT
Valley Stream, NY 11580-1143

Mailing address

48 Central CT
Valley Stream, NY 11580-1143
Phone (516) 593-7747

Other identifiers 2

IdentifierTypeStateIssuer
03047692MedicaidNY
3359533OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Crescent 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
O20211015002134 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2466850862 Practice locations: Valley Stream, NY
O20211122002198 NY DME Supplier - Pharmacy 2466850862 Practice locations: Valley Stream, NY

National Provider Directory

National Provider Directory
Tax ID family
Rex Specialty Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

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": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1649415704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 CENTRAL CT",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801143",
            "telephone_number": "516-593-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CENTRAL CT",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801143",
            "telephone_number": "516-593-7747",
            "fax_number": "516-593-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX SPECIALTY PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "JAFFERY",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "HASSAN",
        "authorized_official_title_or_position": "PRESIDENT/SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "516-593-7747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03047692",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3359533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crescent Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crescent Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.