Beacon Wellness Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

BEACON WELLNESS PHARMACY INC

Practice address

333 Main St
Beacon, NY 12508-3018

Phone

(845) 765-8878

Fax

(845) 765-8884

NPI assigned

Oct 18, 2019

Last updated

Oct 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Enrique Reynoso, RPHNPI 1508387002

Title

Owner

Phone

(845) 765-8878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Enrique Reynoso

  • Pharmacist
  • New York, NY
  • NPI 1508387002
  NPD Authorized official

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1841833183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MAIN ST",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125083018",
            "telephone_number": "845-765-8878",
            "fax_number": "845-765-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MAIN ST",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125083018",
            "telephone_number": "845-765-8878",
            "fax_number": "845-765-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON WELLNESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "REYNOSO",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-765-8878",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.