Organization Active NPI

Mott Haven Prescription Inc

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1720634611
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
MOTT HAVEN PRESCRIPTION INC
Practice address
400 E 141St St
Bronx, NY 10454-2212
Phone
(718) 292-9144
Fax
(718) 292-9145
NPI assigned
Aug 15, 2019
Last updated
Apr 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Authorized official

Name
Ramabhai M Patel
Title
Pharmcist
Phone
(718) 292-9144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X NU Primary

Addresses

Primary practice location

400 E 141St St
Bronx, NY 10454-2212

Mailing address

400 E 141St St
Bronx, NY 10454-2212
Phone (718) 292-9144

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230410000115 NY Part B Supplier - Pharmacy 2163851494 Practice locations: Bronx, NY
O20240708002398 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2163851494 Practice locations: Bronx, 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": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1720634611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 141ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542212",
            "telephone_number": "718-292-9144",
            "fax_number": "718-292-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 141ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542212",
            "telephone_number": "718-292-9144",
            "fax_number": "718-292-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTT HAVEN PRESCRIPTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAMABHAI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMCIST",
        "authorized_official_telephone_number": "718-292-9144"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 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.