Iman Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027817 Issued in NY

Legal business name

IMAN PHARMACY INC

Doing business as

Fleetwood Pharmacy

Practice address

505 Gramatan Ave
Mount Vernon, NY 10552-3008

Phone

(914) 665-5556

Fax

(914) 665-5589

NPI assigned

May 24, 2006

Last updated

Mar 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marwan Abdullah, R.PHNPI 1811213804

Title

President / Pic

Phone

(914) 665-5556

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• FLEETWOOD PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Iman Pharmacy Inc

  • Long Term Care Pharmacy
  • Mount Vernon, NY
  • NPI 1831003425
  NPPES parent name

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.

• Marwan Amin Abdullah, R.PH, CNS

  • Nutrition Support Pharmacist
  • Mount Vernon, NY
  • NPI 1811213804
  NPD Authorized official

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1669427969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523008",
            "telephone_number": "914-665-5556",
            "fax_number": "914-665-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523008",
            "telephone_number": "914-665-5556",
            "fax_number": "914-665-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "ABDULLAH",
        "authorized_official_first_name": "MARWAN",
        "authorized_official_title_or_position": "PRESIDENT / PIC",
        "authorized_official_telephone_number": "914-665-5556",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027817",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068108",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02785711",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLEETWOOD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chioma C J Ibe Pearson
• Rachel Ibezim
• Diana Illescas
• Javier Illescas
• Imaginethat ABA Therapy LLC
• Iman Pharmacy Inc
• Imana RN LLC
• Peter Aleghe Imana, RN
• Impressive Care
• Independence Counseling Center

• Community/Retail Pharmacy in Mount Vernon, NY
• Providers in Mount Vernon, 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 Mar 18, 2015; 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.