Organization Active NPI

Slater Pharmacy Inc

  • Pharmacist
  • Ronkonkoma, NY
National Provider Identifier
1770639072
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042945 Issued in NY
Legal business name
SLATER PHARMACY INC
Practice address
407 Hawkins Ave
Ronkonkoma, NY 11779-4239
Phone
(631) 588-1590
Fax
(631) 981-5681
NPI assigned
Jan 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Steven Neil Weinberg, RPH
Title
Pharmacy Manager
Phone
(631) 588-1590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 042945 NY Primary

Addresses

Primary practice location

407 Hawkins Ave
Ronkonkoma, NY 11779-4239

Mailing address

407 Hawkins Ave
Ronkonkoma, NY 11779-4239
Phone (631) 588-1590

Other identifiers 1

IdentifierTypeStateIssuer
00653250MedicaidNY

National Provider Directory

National Provider Directory

Locations

407 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 588-1590

Practitioners & affiliated clinicians

Practitioners 3

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": "1169856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770639072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HAWKINS AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794239",
            "telephone_number": "631-588-1590",
            "fax_number": "631-981-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 HAWKINS AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794239",
            "telephone_number": "631-588-1590",
            "fax_number": "631-981-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLATER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "631-588-1590",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653250",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.