Longevity Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028788 Issued in NY

Legal business name

LONGEVITY PHARMACY LLC

Practice address

96 E Broadway
New York, NY 10002-7031

Phone

(212) 693-8866

Fax

(815) 425-8920

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Romond Fung

Title

Member

Phone

(212) 693-8866

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• FUZHOU PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Ken Alex Fu, RHP

  • Pharmacist
  • New York, NY
  • NPI 1255512604
  NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1689701484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027031",
            "telephone_number": "212-693-8866",
            "fax_number": "815-425-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 E BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027031",
            "telephone_number": "212-693-8866",
            "fax_number": "815-425-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "ROMOND",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "212-693-8866"
    },
    "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": "028788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FUZHOU PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Trigg Long, MD
• Mary Longest
• Longevity Adult Day Care Center LLC
• Longevity Fi LLC
• Longevity Long Term Medical Care of New York, PLLC
• Daniella Longhi
• Colleen M Longley, MD
• Regina Marie Longley
• Randy Scott Longman, MD / PHD
• Ryan Longman

• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 30, 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.