Canaan Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

017260 Issued in NY

Legal business name

CANAAN PHARMACY INC.

Practice address

6914 5TH Ave
Brooklyn, NY 11209-1507

Phone

(718) 779-4523

Fax

(718) 779-7814

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Krishna Chaluvadi

Title

Director

Phone

(718) 293-9596

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FREEDOM PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronnie Joudeh, PHARM D

  • Pharmacist
  • Brooklyn, NY
  • NPI 1881074185
  NPD (past)
• Yam Lam, PHARMACIST

  • Pharmacist
  • Brooklyn, NY
  • NPI 1396923819
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1669408951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6914 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091507",
            "telephone_number": "718-779-4523",
            "fax_number": "718-779-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6914 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091507",
            "telephone_number": "718-779-4523",
            "fax_number": "718-779-7814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 Junction Blvd",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "NY",
            "postal_code": "113681740",
            "country_code": "US",
            "telephone_number": "718-779-4523",
            "fax_number": "718-779-7814",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "971 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104593237",
            "country_code": "US",
            "telephone_number": "718-779-4523",
            "fax_number": "718-779-7814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANAAN PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "CHALUVADI",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-293-9596"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "017260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00656400",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREEDOM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Campos
• Odalis Marisol Campos
• Vikki Tatiana Campos
• Julia Elizabeth Campoverde-Romero, CCC-SLP
• Jennifer Campoverde, FNP
• Alexsis Canaan
• Marta Alicia Canaan, M.S., OTR/L
• Shericka Canady, LCSW
• Canal Street Pharmacy Incorporated
• Cali Ann Canal, OTR/L

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.