Organization Active NPI

Slavins-Hancock Pharmacy, Inc

  • Pharmacy
  • Stamford, CT
National Provider Identifier
1881793776
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PCY.0000767 Issued in CT
Legal business name
SLAVINS-HANCOCK PHARMACY, INC
Practice address
922 Washington Blvd
Stamford, CT 06901-2204
Phone
(203) 323-2161
Fax
(203) 964-1913
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Lakshmana Pudipeddi
Title
Vice President
Phone
(203) 323-2161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PCY.0000767 CT Primary

Addresses

Primary practice location

922 Washington Blvd
Stamford, CT 06901-2204

Mailing address

922 Washington Blvd
Stamford, CT 06901-2204
Phone (203) 323-2161

Other practice location 1

1035 Washington Blvd
Stamford, CT 06901-2204
Phone (203) 323-2161

Other identifiers 2

IdentifierTypeStateIssuer
2133461OtherPK
008036522MedicaidCT

Other names 1

  • SLAVINS-HANCOCK PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20131004000560 CT DME Supplier - Pharmacy 7214161298 Practice locations: Stamford, CT
O20190308000764 CT Part B Supplier - Mass Immunization (Roster Biller Only) 7214161298 Practice locations: Stamford, CT
O20210122001607 CT Part B Supplier - Pharmacy 7214161298 Practice locations: Stamford, CT

National Provider Directory

National Provider Directory
Tax ID family
Slavins Professional Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1035 Washington Blvd
Stamford, CT 06901
Phone (203) 323-2161

922 Washington Blvd
Stamford, CT 06901
Phone (203) 305-6109

Practitioners & affiliated clinicians

Practitioners 4

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": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881793776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 WASHINGTON BLVD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012204",
            "telephone_number": "203-323-2161",
            "fax_number": "203-964-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WASHINGTON BLVD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012204",
            "telephone_number": "203-323-2161",
            "fax_number": "203-964-1913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069012204",
            "country_code": "US",
            "telephone_number": "203-323-2161",
            "fax_number": "203-964-1913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SLAVINS-HANCOCK PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "PUDIPEDDI",
        "authorized_official_first_name": "LAKSHMANA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "203-323-2161"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "PCY.0000767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133461",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008036522",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLAVINS-HANCOCK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.