2205 Health Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

2205 HEALTH INC

Practice address

1871 86TH St
Brooklyn, NY 11214-3108

Phone

(718) 232-4912

Fax

(718) 228-8523

NPI assigned

Jul 8, 2021

Organization subpart

No

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

Authorized official

Name

Vu N Quach

Title

President

Phone

(718) 232-4912

Specialties & licenses 3

Addresses

Other names 1

• Medland Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

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

Locations

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1750952933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-232-4912",
            "fax_number": "718-228-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-232-4912",
            "fax_number": "718-228-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2205 HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "QUACH",
        "authorized_official_first_name": "VU",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-232-4912"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medland Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medland Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Brooklyn, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.