Organization Active NPI

Hargraves Pharmacy Inc.

  • Community/Retail Pharmacy
  • Fulton, NY
National Provider Identifier
1689794547
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
034623 Issued in NY
Legal business name
HARGRAVES PHARMACY INC.
Practice address
113 W Broadway
Fulton, NY 13069-2215
Phone
(315) 592-4335
Fax
(315) 592-3356
NPI assigned
Apr 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Authorized official

Name
Robert Joseph Lanzafame
Title
Supervising Pharmacist
Phone
(315) 592-4335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 034623 NY Primary

Addresses

Primary practice location

113 W Broadway
Fulton, NY 13069-2215

Mailing address

113 W Broadway
Fulton, NY 13069-2215
Phone (315) 592-4335

Other identifiers 1

IdentifierTypeStateIssuer
00560756MedicaidNY

National Provider Directory

National Provider Directory

Locations

113 W Broadway
Fulton, NY 13069
Phone (315) 592-4335

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": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1689794547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692215",
            "telephone_number": "315-592-4335",
            "fax_number": "315-592-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692215",
            "telephone_number": "315-592-4335",
            "fax_number": "315-592-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARGRAVES PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "LANZAFAME",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "315-592-4335"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00560756",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.