Vida Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VIDA PHARMACY LLC

Practice address

172 Bushwick Ave
Brooklyn, NY 11206-1604

Phone

(347) 725-7953

Fax

(347) 725-4794

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Salim Faour, PHARM.DNPI 1639482151

Title

Pharmacist

Phone

(917) 442-2705

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

Tax ID family

Vida Pharmacy LLC2 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.

• Vida Pharmacy LLC

  • Long Term Care Pharmacy
  • Brooklyn, NY
  • NPI 1942030622
  NPD tax ID

Locations

Practitioners 1

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

• Salim Faour, PHARM.D

  • Pharmacist
  • Brooklyn, NY
  • NPI 1639482151
  NPD (past) Authorized official

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1689012544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 BUSHWICK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112061604",
            "telephone_number": "347-725-7953",
            "fax_number": "347-725-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 BUSHWICK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112061604",
            "telephone_number": "347-725-7953",
            "fax_number": "347-725-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "FAOUR",
        "authorized_official_first_name": "SALIM",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "917-442-2705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Vision Care Inc.
• Victory Vision Center LLC
• Errol Christopher Victory
• Jesse Martin Victory, D.O.
• Victoria Vicuna
• Vida Pharmacy LLC
• Yelina Vidal
• Michelle S Vidale, TSLD
• Alexander Vidershayn
• Joseph Nicholas Videtto, OTR/L

• 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 Aug 6, 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.