Organization Active NPI

Umamah Pitkin Pharmacy Inc

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1679618060
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
UMAMAH PITKIN PHARMACY INC
Practice address
2231 Pitkin Ave
Brooklyn, NY 11207
Phone
(718) 485-3724
Fax
(718) 495-3290
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Sara Mansour
Title
President
Phone
(718) 384-5917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

2231 Pitkin Ave
Brooklyn, NY 11207

Mailing address

2231 Pitkin Avenue
Brooklyn, NY 11207
Phone (718) 485-3724

Other identifiers 1

IdentifierTypeStateIssuer
01228160MedicaidNY

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930091456 NY DME Supplier - Pharmacy 2668583733 Practice locations: Brooklyn, NY
O20241118003605 NY Part B Supplier - Pharmacy 2668583733 Practice locations: Brooklyn, NY
O20260112001184 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2668583733 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Umamah Pitkin Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2231 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 485-3724

Practitioners & affiliated clinicians

Practitioners 3

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1679618060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 PITKIN AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-485-3724",
            "fax_number": "718-495-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-485-3724",
            "fax_number": "718-495-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMAMAH PITKIN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-384-5917"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01228160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.