Active NPI
Havemeyer Pharmacy Inc
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1851665954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 031088
- Legal business name
- HAVEMEYER PHARMACY INC
- Practice address
- 259 S 2ND St
Brooklyn, NY 11211-8699 - Phone
- (718) 599-5991
- Fax
- (718) 599-5992
- NPI assigned
- Mar 7, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Bassanell
- Title
- Pharmacist
- Phone
- (646) 234-4181
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 031088 | NY | Primary |
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Long Term Care Pharmacy | 3336L0003X | |||
| Mail Order Pharmacy | 3336M0002X | |||
| Managed Care Organization Pharmacy | 3336M0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
259 S 2ND St
Brooklyn, NY 11211-8699
Mailing address
269 S 2ND St
Brooklyn, NY 11211-5449
Phone (718) 599-5991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2134354 | Other | PK |
Other names 1
- Southside Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240201000102 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 7315103595 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- New York, NY
- NPI 1801998505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705536000000",
"number": "1851665954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 S 2ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112115449",
"telephone_number": "718-599-5991",
"fax_number": "718-599-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 S 2ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112118699",
"telephone_number": "718-599-5991",
"fax_number": "718-599-5992"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAVEMEYER PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-07",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A",
"authorized_official_last_name": "BASSANELL",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "646-234-4181"
},
"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": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "031088",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336M0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Mail Order Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336M0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Managed Care Organization 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": "2134354",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Southside Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.