Organization Active NPI

Lenox Avenue North Corp

Doing business as palace pharmacy

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1700412186
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LENOX AVENUE NORTH CORP
Doing business as
palace pharmacy
Practice address
543 Lenox Ave
New York, NY 10037-1806
Phone
(212) 283-2136
Fax
(212) 283-2463
NPI assigned
Mar 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Authorized official

Name
Oumar Tangara
Title
Owner
Phone
(917) 459-2518

Specialties & licenses 1

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

Addresses

Primary practice location

543 Lenox Ave
New York, NY 10037-1806

Mailing address

543 Lenox Ave
New York, NY 10037-1806
Phone (212) 283-2136

Other names 1

  • palace pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201209002066 NY DME Supplier - Pharmacy 5698187052 Practice locations: New York, NY
O20220712000544 NY Part B Supplier - Pharmacy 5698187052 Practice locations: New York, 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": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1700412186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371806",
            "telephone_number": "212-283-2136",
            "fax_number": "212-283-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371806",
            "telephone_number": "212-283-2136",
            "fax_number": "212-283-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENOX AVENUE NORTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "TANGARA",
        "authorized_official_first_name": "OUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-459-2518"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "palace pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.