Organization Active NPI

D and B Pharmacy Corporation

  • Community/Retail Pharmacy
  • South Salem, NY
National Provider Identifier
1669577433
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
026096 Issued in NY
Legal business name
D AND B PHARMACY CORPORATION
Practice address
222 Oakridge CMNS
South Salem, NY 10590-2437
Phone
(914) 533-5679
Fax
(914) 533-5222
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Paul Roldan, RPHNPI 1629226329
Title
President
Phone
(914) 533-5679

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
Community/Retail Pharmacy 3336C0003X 026096 NY Primary

Addresses

Primary practice location

222 Oakridge CMNS
South Salem, NY 10590-2437

Mailing address

PO Box 765
New City, NY 10956-0765
Phone (914) 533-5679

Other identifiers 2

IdentifierTypeStateIssuer
02493805MedicaidNY
2060219OtherPK

Other names 1

  • PAUL'S PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930084758 NY DME Supplier - Pharmacy 2567663156 Practice locations: South Salem, NY
O20150904001476 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2567663156 Practice locations: South Salem, NY
O20230508001479 NY Part B Supplier - Independent Clinical Laboratory 2567663156 Practice locations: South Salem, 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2254605Paul'S Pharmacy222 Oakridge Common, South Salem, NY 10590Certificate of waiverMar 26, 2027

National Provider Directory

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1669577433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 765",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109560765",
            "telephone_number": "914-533-5679",
            "fax_number": "914-533-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 OAKRIDGE CMNS",
            "city": "SOUTH SALEM",
            "state": "NY",
            "postal_code": "105902437",
            "telephone_number": "914-533-5679",
            "fax_number": "914-533-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D AND B PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-533-5679",
        "authorized_official_credential": "RPH"
    },
    "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": "026096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02493805",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2060219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAUL'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Salem, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.