San RX Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

026421 Issued in NY

Legal business name

SAN RX INC

Practice address

801 Nostrand Ave
Brooklyn, NY 11225-1507

Phone

(718) 953-4548

Fax

(718) 953-4601

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Balaji Duddukuru

Title

President

Phone

(718) 953-4548

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PARK DRUGS 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.

• Saritha Jillella

  • Pharmacist
  • Browns Mills, NJ
  • NPI 1154636496
  NPD
• Gautam Kumar Nirmal, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1427119221
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1669417002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112251507",
            "telephone_number": "718-953-4548",
            "fax_number": "718-953-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112251507",
            "telephone_number": "718-953-4548",
            "fax_number": "718-953-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "DUDDUKURU",
        "authorized_official_first_name": "BALAJI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-953-4548"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "026421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02459218",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2062911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARK DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krissa Lee Samuelson
• Jeanette Samyn, PHD
• Meghan Samyn, CCC-SLP
• Angela Lopez San Jose, PT
• Hannah Marie Cruz San Jose, OTR/L
• San San Wynn, M.D., P.C.
• Htet San, MD
• Khaingthazin San, MD
• Mon Mon Myint San, M.D.,
• Myat San, M.D.

• 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 29, 2021; 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.