Express Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025578 Issued in NY

Legal business name

EXPRESS DRUG STORE INC

Practice address

1408 Avenue J
Brooklyn, NY 11230-3702

Phone

(718) 677-5800

Fax

(718) 677-0708

NPI assigned

Nov 6, 2005

Last updated

Dec 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dmitriy Perelman, PHARMDNPI 1609857515

Title

VP

Phone

(718) 677-5800

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dmitriy R Perelman, PHARMD

  • Pharmacist
  • Brooklyn, NY
  • NPI 1609857515
  NPD (past) Authorized official

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

{
    "created_epoch": "1131235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1750362992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303702",
            "telephone_number": "718-677-5800",
            "fax_number": "718-677-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303702",
            "telephone_number": "718-677-5800",
            "fax_number": "718-677-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-06",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "PERELMAN",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "718-677-5800",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4858750001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3329946",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02374990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Express Medical PC
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• Express Pharmacy, Inc. (Amiable Pharmacy)
• Express Rehab Care PT,PC
• Expression Connection LLC

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.