Organization Active NPI

JRJ Raisell Pharmacy Drug Corp

  • Pharmacy
  • Bronx, NY
National Provider Identifier
1871072579
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
JRJ RAISELL PHARMACY DRUG CORP
Practice address
741 Astor Ave
Bronx, NY 10467-9307
Phone
(347) 955-3344
Fax
(347) 955-3347
NPI assigned
Aug 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Jose Luis Susana
Title
President
Phone
(212) 304-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

741 Astor Ave
Bronx, NY 10467-9307

Mailing address

741 Astor Ave
Bronx, NY 10467-9307
Phone (347) 955-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190131002401 NY DME Supplier - Pharmacy 0042557878 Practice locations: Bronx, NY
O20211213000535 NY Part B Supplier - Pharmacy 0042557878 Practice locations: Bronx, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
JRJ Raisell Pharmacy Drug Corp741 Astor Ave, Bronx, NY 10467-9307(347) 955-3344 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 3, 2021

National Provider Directory

National Provider Directory

Locations

741 Astor Ave
Bronx, NY 10467
Phone (347) 955-3344

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1871072579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 ASTOR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104679307",
            "telephone_number": "347-955-3344",
            "fax_number": "347-955-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 ASTOR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104679307",
            "telephone_number": "347-955-3344",
            "fax_number": "347-955-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRJ RAISELL PHARMACY DRUG CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "SUSANA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-304-0101"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.