Condo Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027910 Issued in NY

Legal business name

CONDO PHARMACY INC

Practice address

28 Montcalm Ave
Plattsburgh, NY 12901-1533

Phone

(518) 563-3400

Fax

(518) 563-5946

NPI assigned

Oct 11, 2005

Organization subpart

No

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

Authorized official

Name

Steve Moore, PHARMD

Title

Vice President,Ao

Phone

(518) 563-3400

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• Condo Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1811985161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MONTCALM AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011533",
            "telephone_number": "518-563-3400",
            "fax_number": "518-563-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MONTCALM AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011533",
            "telephone_number": "518-563-3400",
            "fax_number": "518-563-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VICE PRESIDENT,AO",
        "authorized_official_telephone_number": "518-563-3400",
        "authorized_official_credential": "PHARMD"
    },
    "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": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027910",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063370",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02785835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Condo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane Elizabeth Colquhoun, LCSWR
• Laurel E Colvin, FNP-C
• Jaclyn R Combes, PA
• Chelsey Annette Compeau, M.A. SLP
• Condo Pharmacy Inc
• Condo Pharmacy, Inc
• Conifer Park, Inc.
• Jacquelyn Connelly, PH.D.
• Hannah Constanty, A-GNP-C
• Anthony Gabriel Conti, MD

• Community/Retail Pharmacy in Plattsburgh, NY
• Providers in Plattsburgh, 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 Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.