Patchogue Pharmacy, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

036707 Issued in NY

Legal business name

PATCHOGUE PHARMACY, INC

Practice address

176 W Main St
Patchogue, NY 11772-3004

Phone

(631) 438-8100

Fax

(631) 438-0738

NPI assigned

Aug 7, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Tomas Diaz, RPH

Title

President

Phone

(631) 438-8100

Specialties & licenses 1

Addresses

Other names 1

• SaluMed Pharmacy Patchogue Doing business as

Locations

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1891127346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 W MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723004",
            "telephone_number": "631-438-8100",
            "fax_number": "631-438-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 W MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723004",
            "telephone_number": "631-438-8100",
            "fax_number": "631-438-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATCHOGUE PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-438-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "036707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SaluMed Pharmacy Patchogue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Patchogue Physical Therapy PC
• Patchogue Supermarkets LLC
• Patchogue Transportation Corp.
• Patchogue Urgent Care, P.C.
• Patchogue-Medford PT & Chiropractic PLLC

• Pharmacy in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.