NPIMap

Organization Active NPI

Martins Foods of South Burlington LLC

  • Community/Retail Pharmacy
  • Wynantskill, NY
National Provider Identifier
1780792168
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
022741 Issued in NY
Legal business name
MARTINS FOODS OF SOUTH BURLINGTON LLC
Practice address
40 Main Ave
Wynantskill, NY 12198-7541
Phone
(518) 283-0841
Fax
(518) 286-2257
NPI assigned
Aug 27, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Michael Vail
Title
President and Manager
Phone
(207) 885-7454

Other NPIs on the same Medicare enrollment 45

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

View all 45

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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
Martin'S Foods of South Burlington,40 Main Ave, Wynantskill, NY 12198-7541(518) 283-0841 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930018735 NY DME Supplier - PharmacyDME Supplier - Grocery Store 7517085293 Practice locations: Wynantskill, NY
O20111031000005 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7517085293 45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Hartford, NY; New Windsor, NY; Niskayuna, NY; Oneonta, NY; Pawling, NY; Pine Bush, NY; Plattsburgh, NY; Queensbury, NY…

National Provider Directory

National Provider Directory
Tax ID family
Shop N Save Pharmacy60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

40 Main Ave
Wynantskill, NY 12198
Phone (518) 283-0841

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 022741 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

40 Main Ave
Wynantskill, NY 12198-7541

Mailing address

PO Box 1000
Ms 3000
Portland, ME 04104-5005
Phone (207) 885-7454

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
01614511MedicaidNY
2059222OtherPK

Other names 1

NPPES NPI Registry
  • HANNAFORD FOOD AND DRUG Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2025.

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1780792168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MS 3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "704-645-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MAIN AVE",
            "city": "WYNANTSKILL",
            "state": "NY",
            "postal_code": "121987541",
            "telephone_number": "518-283-0841",
            "fax_number": "518-286-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINS FOODS OF SOUTH BURLINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "VAIL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT AND MANAGER",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "022741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01614511",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2059222",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HANNAFORD FOOD AND DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wynantskill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.