Organization Active NPI

Jericho Pharmacy Corp

  • Community/Retail Pharmacy
  • Syosset, NY
National Provider Identifier
1851675714
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
030920 Issued in NY
Legal business name
JERICHO PHARMACY CORP
Practice address
340 Jericho Tpke
Syosset, NY 11791-4507
Phone
(516) 864-0020
Fax
(516) 864-0021
NPI assigned
Oct 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Authorized official

Name
Philip Cherian, RPHNPI 1013145010
Title
President
Phone
(516) 934-0174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 030920 NY Primary

Addresses

Primary practice location

340 Jericho Tpke
Syosset, NY 11791-4507

Mailing address

340 Jericho Tpke
Syosset, NY 11791-4507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403001486 NY Part B Supplier - Pharmacy 7517120165 Practice locations: Syosset, NY

National Provider Directory

National Provider Directory

Locations

340 Jericho Tpke
Syosset, NY 11791
Phone (516) 864-0020

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1851675714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 JERICHO TPKE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 JERICHO TPKE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914507",
            "telephone_number": "516-864-0020",
            "fax_number": "516-864-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERICHO PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "CHERIAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-934-0174",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.