Organization Active NPI

Citi Express Pharmacy and Medical Supplies LLC

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1649754904
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CITI EXPRESS PHARMACY AND MEDICAL SUPPLIES LLC
Practice address
4217 Church Ave
Brooklyn, NY 11203-3011
Phone
(718) 355-8800
Fax
(646) 588-0462
NPI assigned
Sep 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Ms. Marlyjean Raymond-Joseph
Title
Pharmacist
Phone
(718) 355-8800

Specialties & licenses 1

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

Addresses

Primary practice location

4217 Church Ave
Brooklyn, NY 11203-3011

Mailing address

4217 Church Ave
Brooklyn, NY 11203-3011
Phone (718) 355-8800

Other identifiers 1

IdentifierTypeStateIssuer
1760639108MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190401002360 NY DME Supplier - Pharmacy 5294076253 Practice locations: Brooklyn, NY
O20230612000044 NY Part B Supplier - Pharmacy 5294076253 Practice locations: Brooklyn, 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
Citi Express Pharmacy and Medical4217 Church Ave, Brooklyn, NY 11203-3011(718) 355-8800 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since May 22, 2023

National Provider Directory

National Provider Directory

Locations

4217 Church Ave
Brooklyn, NY 11203
Phone (718) 355-8800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1649754904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033011",
            "telephone_number": "718-355-8800",
            "fax_number": "646-588-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033011",
            "telephone_number": "718-355-8800",
            "fax_number": "646-588-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITI EXPRESS PHARMACY AND MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-21",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "RAYMOND-JOSEPH",
        "authorized_official_first_name": "MARLYJEAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-355-8800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760639108",
            "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 May 17, 2023; 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.