The Medicine Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028674 Issued in NY

Legal business name

THE MEDICINE STORE INC

Doing business as

Health Mart Pharmacy

Practice address

5 Candlewood Rd
Bay Shore, NY 11706-2351

Phone

(631) 300-4670

Fax

(631) 300-4673

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Demetris PavlouNPI 1295915619

Title

President

Phone

(631) 300-4670

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Health Mart Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Member of 1

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

• D.R.a. Pharmakon Inc

  dba D's Pharmacy

  • Pharmacy
  • Hempstead, NY
  • NPI 1457790503

  Member Of

  NPD member

Locations

Practitioners 1

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

• Demetris Pavlou

  • Pharmacist
  • Bay Shore, NY
  • NPI 1295915619
  NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1780866509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CANDLEWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062351",
            "telephone_number": "631-300-4670",
            "fax_number": "631-300-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CANDLEWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062351",
            "telephone_number": "631-300-4670",
            "fax_number": "631-300-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICINE STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "PAVLOU",
        "authorized_official_first_name": "DEMETRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-300-4670"
    },
    "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": "NY",
            "license": "028674",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2069992",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2936345",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lincy Simon Thadathil, D.O.
• Sarumathi Thangavel, M.D.
• The Body of Christ, Youth and Adult Counseling Center, Corp
• The Healthcare Store, Inc.
• The Marsh Group Counseling Services, LLC
• Theradynamics Physical Rehab
• Vani Thiyagarajan, PHARMD
• Betsy Thomas
• Chelsea Megan Thomas
• Justin Michael Thomas, M.D.

• Community/Retail Pharmacy in Bay Shore, NY
• Providers in Bay Shore, 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 Feb 27, 2017; 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.