Memorial Sloan Kettering Cancer Center
Organization Active NPI Community/Retail Pharmacy · Commack, NY
NPI 1831601772 · NPPES record last updated Mar 19, 2024
Key facts
- NPI
- 1831601772
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 025357 (NY)
- Legal business name
- MEMORIAL SLOAN KETTERING CANCER CENTER
- Practice address
- 650 Commack Rd Ste 1401
Commack, NY 11725-5404 - Phone
- (631) 212-6110
- NPI assigned
- Nov 1, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES
Authorized official
- Name
- Susan Murillo
- Title
- Pharmacy Manager
- Phone
- (212) 639-2206
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 20
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Memorial Sloan Kettering at Commack |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190918002833 | NY | DME Supplier - Pharmacy | 9931304375 | Practice locations: Commack, NY |
| O20220502000985 | NY | Part B Supplier - Pharmacy | 9931304375 |
7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Commack, NY; Long Island City, NY; New York, NY; West Harrison, NY |
National Provider Directory
- Tax ID family
- Memorial Sloan Kettering Cancer Center
- Part of
- Memorial Sloan Kettering Cancer Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 025357 | NY | Yes |
Addresses
Primary practice location
650 Commack Rd Ste 1401
Commack, NY 11725-5404
Mailing address
1275 York Ave RM H-313
New York, NY 10065-6007
Phone (212) 639-2206
Other names
- Memorial Sloan Kettering at Commack Retail
Other providers in Commack, NY
- Medical Integrity PLLC
- Magdalena Elizabeth Medina
- Tal Mednick
- Paul J Meller
- Jillian Leigh Mellon
- Menasis-Matuza, Nurse Practitioner in Pediatrics, PC
- Ivy Tan Meneses
- John-Rex Pascual Meneses
- Mental Health Counseling Office of Adrian Fields Boyer, PLLC
- Mental Health Counseling Therapeutic Services PLLC
All providers in Commack, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.