NPIMap

Organization Active NPI

Suny Health Science Center at Syracuse

Doing business as State University of New York Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Syracuse, NY
National Provider Identifier
1740796697
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
035949 Issued in NY
Legal business name
SUNY HEALTH SCIENCE CENTER AT SYRACUSE
Doing business as
State University of New York Outpatient Pharmacy
Practice address
750 E Adams St
Outpatient Pharmacy
Syracuse, NY 13210
Phone
(315) 464-3784
Fax
(315) 464-9995
NPI assigned
Dec 14, 2017
Last updated
May 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Authorized official

Name
Stuart Wright
Title
Cfo
Phone
(315) 464-6530

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X 035949 NY Primary
Mail Order Pharmacy 3336M0002X NU
Specialty Pharmacy 3336S0011X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

750 E Adams St
Outpatient Pharmacy
Syracuse, NY 13210

Mailing address

750 East Adams St
Outpatient Pharmacy
Syracuse, NY 13210
Phone (315) 464-3784

Other identifiers 1

IdentifierTypeStateIssuer
2174989OtherPK

Other names 1

  • State University of New York Outpatient 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
O20180517002069 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7214833086 1 other NPI on this enrollment
Practice locations: Syracuse, NY
O20180630000164 NY DME Supplier - Pharmacy 7214833086 Practice locations: Syracuse, NY

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
Suny Health Science Center at Syrac750 E Adams St, Syracuse, NY 13210-2306(315) 464-3784 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Suny Healthscience Center at Syracuse11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1740796697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "address_2": "OUTPATIENT PHARMACY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-3784",
            "fax_number": "315-464-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "OUTPATIENT PHARMACY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-3784",
            "fax_number": "315-464-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNY HEALTH SCIENCE CENTER AT SYRACUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-464-6530"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035949",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2174989",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State University of New York Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "State University of New York Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.