Elderberry Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ELDERBERRY PHARMACY INC

Practice address

2095 Madison Ave
New York, NY 10037-3449

Phone

(212) 491-2501

Fax

(212) 491-2502

NPI assigned

Mar 3, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Ronak Raval

Title

President

Phone

(212) 491-2501

Specialties & licenses 1

Addresses

Other names 1

• ABC DRUGS Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1891442547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100373449",
            "telephone_number": "212-491-2501",
            "fax_number": "212-491-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100373449",
            "telephone_number": "212-491-2501",
            "fax_number": "212-491-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERBERRY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "RAVAL",
        "authorized_official_first_name": "RONAK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-491-2501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward Byers Elder, M.H.S., M.DIV.
• Jeanne Andresakes Elder, MHC
• Joseph David Elder, MA, LMT
• Mary Ellen Elder, LCSW
• Sandra Elder, SANDRA ELDER, MHC-LP
• Jenna M. Eldib, PHARMD
• Seif Abobakr Mohamed Eldib, RPH
• Marwa Eldik, MD
• Erica Rae Eldon, DO
• Jenna Eldred

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.