Organization Active NPI

Purecare Pharmacy Corp

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1720803604
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
PURECARE PHARMACY CORP
Doing business as
PureCare Pharmacy Corp
Practice address
8409 5TH Ave
Brooklyn, NY 11209-4709
Phone
(347) 492-0211
Fax
(347) 492-0085
NPI assigned
Nov 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Ahmed Nasser, PHARMACISTNPI 1356705602
Title
Pharmacist
Phone
(419) 329-8825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

8409 5TH Ave
Brooklyn, NY 11209-4709

Mailing address

8409 5TH Ave
Brooklyn, NY 11209-4709
Phone (347) 492-0211

Other names 1

  • PureCare Pharmacy Corp Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20250312001983 NY Part B Supplier - Mass Immunization (Roster Biller Only) 5890216303 Practice locations: Brooklyn, NY
O20250317000795 NY Part B Supplier - Pharmacy 5890216303 Practice locations: Brooklyn, NY
O20250401000585 NY DME Supplier - Pharmacy 5890216303 Practice locations: Brooklyn, 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2324785Purecare+ Pharmacy Corp8409 5TH Ave, Brooklyn, NY 11209Certificate of waiverMar 26, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Purecare Pharmacy Corp8409 5TH Ave, Brooklyn, NY 11209-4709(347) 492-0211 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 4, 2025

National Provider Directory

National Provider Directory

Locations

8409 5th Ave
Brooklyn, NY 11209
Phone (347) 492-0211

Practitioners & affiliated clinicians

Practitioners 2

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": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1720803604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8409 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094709",
            "telephone_number": "347-492-0211",
            "fax_number": "347-492-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8409 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094709",
            "telephone_number": "347-492-0211",
            "fax_number": "347-492-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURECARE PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-17",
        "status": "A",
        "authorized_official_last_name": "NASSER",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "419-329-8825",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PureCare Pharmacy Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

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