Organization Active NPI

Baldwin Pharmacy LLC

  • Community/Retail Pharmacy
  • North Baldwin, NY
National Provider Identifier
1871075655
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BALDWIN PHARMACY LLC
Practice address
1927 Grand Ave
North Baldwin, NY 11510-2818
Phone
(516) 544-4454
Fax
(516) 608-5059
NPI assigned
Aug 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Mohammed A Ullah
Title
President
Phone
(516) 544-4454

Specialties & licenses 1

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

Addresses

Primary practice location

1927 Grand Ave
North Baldwin, NY 11510-2818

Mailing address

1927 Grand Ave
North Baldwin, NY 11510-2818
Phone (516) 544-4454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190927000679 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1951642420 Practice locations: North Baldwin, NY

National Provider Directory

National Provider Directory

Locations

1927 Grand Ave
North Baldwin, NY 11510
Phone (516) 544-4454

Practitioners & affiliated clinicians

Practitioners 2

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": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1871075655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 GRAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102818",
            "telephone_number": "516-544-4454",
            "fax_number": "516-608-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 GRAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102818",
            "telephone_number": "516-544-4454",
            "fax_number": "516-608-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "ULLAH",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-544-4454"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.