Vida Mas Pharmacia Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VIDA MAS PHARMACIA INC

Practice address

63 Wicks Rd
Brentwood, NY 11717-3523

Phone

(631) 435-7979

Fax

(631) 435-7978

NPI assigned

Apr 27, 2022

Organization subpart

No

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

Authorized official

Name

Roshel Sionov

Title

President

Phone

(631) 435-7979

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• VIDA MAS FARMACIA Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Vida Mas Pharmacia Inc

  • Community/Retail Pharmacy
  • Huntington Station, NY
  • NPI 1831951045

  3678955804

  Same PAC ID

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": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1811632573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 WICKS RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173523",
            "telephone_number": "631-435-7979",
            "fax_number": "631-435-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 WICKS RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173523",
            "telephone_number": "631-435-7979",
            "fax_number": "631-435-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA MAS PHARMACIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "SIONOV",
        "authorized_official_first_name": "ROSHEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-435-7979"
    },
    "taxonomies": [
        {
            "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "039147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIDA MAS FARMACIA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VIDA MAS FARMACIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Marie Venendaal
• Diamond Venzen
• Veritas Medical Care LLC
• Maria Del Rosario Vesey, M.D.
• Emmanuella E Viard, NURSE PRACTITIONER
• Julissa Abigail Villalta Martinez
• Danessia Villatoro, LMSW
• Mayda Lidia Villatoro
• Saida Rosivel Vilorio-Garcia, RN
• Vincent Leddy MD PC

• Community/Retail Pharmacy in Brentwood, NY
• Providers in Brentwood, 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 May 23, 2024; 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.