Nunda Family Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027179 Issued in NY

Legal business name

NUNDA FAMILY PHARMACY LLC

Practice address

12 N State St
Nunda, NY 14517-0518

Phone

(585) 468-2416

Fax

(585) 468-5705

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Jeremiah Axtell, RPHNPI 1265502942

Title

Owner

Phone

(585) 468-2416

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NUNDA FAMILY PHARMACY LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremiah S Axtell, RPH

  • Pharmacist
  • Nunda, NY
  • NPI 1265502942
  NPD Authorized official
• James Paul Byrnes, RPH

  • Pharmacist
  • Nunda, NY
  • NPI 1083939565
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1851484166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "NUNDA",
            "state": "NY",
            "postal_code": "145170518",
            "telephone_number": "585-468-2416",
            "fax_number": "585-468-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N STATE ST",
            "city": "NUNDA",
            "state": "NY",
            "postal_code": "145170518",
            "telephone_number": "585-468-2416",
            "fax_number": "585-468-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUNDA FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "AXTELL",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-468-2416",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02655952",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063750",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NUNDA FAMILY PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Lee Herman, LPN
• Brian Michael Hierl, RN
• Tiffany M Kibler, LPN
• Sheila Lynn McTarnaghan, LPN
• Courtney Lynn Nugent
• Nunda Physical Therapy PLLC
• Joanne Lee Quait, R.N.
• R & D Vision Inc
• Hannah Saile, PA-C
• Donna Sayadoff-Flaherty, PA-C

• All providers in Nunda, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.