Organization Active NPI

Vital RX Corp

Doing business as Shakespeare Pharmacy

  • Pharmacy
  • Bronx, NY
National Provider Identifier
1700490190
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
VITAL RX CORP
Doing business as
Shakespeare Pharmacy
Practice address
1252 Shakespeare Ave
Bronx, NY 10452-3012
Phone
(718) 588-4100
Fax
(718) 588-4200
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Gloria M Reyes-Gavarette
Title
President
Phone
(718) 588-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

1252 Shakespeare Ave
Bronx, NY 10452-3012

Mailing address

1252 Shakespeare Ave
Bronx, NY 10452-3012
Phone (718) 588-4100

Other names 1

  • Shakespeare 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
O20220709000693 NY DME Supplier - Pharmacy 7911394762 Practice locations: Bronx, NY
O20221202000365 NY Part B Supplier - Pharmacy 7911394762 Practice locations: Bronx, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Vital RX Corp Dba Shakespeare Pharm1252 Shakespeare Ave, Bronx, NY 10452-3012(718) 588-4100 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 7, 2022

National Provider Directory

National Provider Directory

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": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1700490190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 SHAKESPEARE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523012",
            "telephone_number": "718-588-4100",
            "fax_number": "718-588-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 SHAKESPEARE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523012",
            "telephone_number": "718-588-4100",
            "fax_number": "718-588-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL RX CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "REYES-GAVARETTE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-588-4100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shakespeare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shakespeare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.