Organization Active NPI

Elmway II Pharmacy Inc

  • Community/Retail Pharmacy
  • Elmhurst, NY
National Provider Identifier
1699154732
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
033562 Issued in NY
Legal business name
ELMWAY II PHARMACY INC
Practice address
8607 51St Ave
Elmhurst, NY 11373-3922
Phone
(718) 699-1882
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Tristan Liu
Title
Corp. Officer
Phone
(718) 699-1882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 033562 NY Primary

Addresses

Primary practice location

8607 51St Ave
Elmhurst, NY 11373-3922

Mailing address

8607 51St Ave
Elmhurst, NY 11373-3922
Phone (718) 699-1882

Other identifiers 1

IdentifierTypeStateIssuer
0033562OtherNYNYS BOARD OF PHARMACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171219002849 NY DME Supplier - Pharmacy 7517225634 Practice locations: Elmhurst, NY
O20210114002383 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7517225634 Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1699154732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 51ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733922",
            "telephone_number": "718-699-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 51ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733922",
            "telephone_number": "718-699-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMWAY II PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CORP. OFFICER",
        "authorized_official_telephone_number": "718-699-1882"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "033562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS BOARD OF PHARMACY",
            "identifier": "0033562",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.