102 Center Care Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

102 CENTER CARE PHARMACY INC

Practice address

102-05B Northern Blvd
Corona, NY 11368

Phone

(718) 587-9010

Fax

(718) 587-9009

NPI assigned

Apr 19, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Miguel Angel Baron, RPHNPI 1508049347

Title

Owner/Pharmacist

Phone

(718) 587-9010

Specialties & licenses 3

Addresses

Other names 1

• CENTER CARE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Miguel Baron, PHARMACIST

  • Pharmacist
  • New York, NY
  • NPI 1508049347
  NPD Authorized official

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1679260855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102-05B NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-587-9010",
            "fax_number": "718-587-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102-05B NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-587-9010",
            "fax_number": "718-587-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "102 CENTER CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "BARON",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANGEL",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "718-587-9010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Corona, NY
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.