Medpack LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

032803 Issued in NY

Legal business name

MEDPACK LLC

Practice address

5923 Strickland Ave
Brooklyn, NY 11234-6435

Phone

(347) 506-1000

Fax

(718) 975-7755

NPI assigned

Jun 24, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Samir Bhagat

Title

Ceo

Phone

(347) 506-1000

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1801201231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231023",
            "telephone_number": "347-506-1000",
            "fax_number": "718-975-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 STRICKLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346435",
            "telephone_number": "347-506-1000",
            "fax_number": "718-975-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "BHAGAT",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-506-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "032803",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "032803",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "032803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "032803",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bronislav Mednik
• Roslyn Medoff-Rivera, LPN
• Marie Yves Medor, LPN
• Inna Medow, LICENSED OPTICIAN
• Marsha Ellen Medows, M.D.
• Medplaza Optical Inc
• Medpro Homecare Agency, Inc
• Medpro Mobile Services LLC
• Medpro Pharmacy
• Medprom Inc

• Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.