Proscript Pharmacy MGMT LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

026894 Issued in NY

Legal business name

PROSCRIPT PHARMACY MGMT LLC

Practice address

1441 South Ave Ste 703
Staten Island, NY 10314-3784

Phone

(866) 646-1780

Fax

(347) 897-4660

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Gina Debartolome

Title

Coo

Phone

(347) 897-4670

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PROSCRIPT PHARMACY MGMT LLC Doing business as

Locations

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1831238880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 SOUTH AVE STE 703",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 SOUTH AVE STE 703",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143784",
            "telephone_number": "866-646-1780",
            "fax_number": "347-897-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSCRIPT PHARMACY MGMT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "DEBARTOLOME",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "347-897-4670"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NY",
            "license": "026894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3343453",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROSCRIPT PHARMACY MGMT LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROSCRIPT PHARMACY MGMT LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mail Order Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mail Order Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.