NPIMap

Organization Active NPI

Pharmacy Associates of Glens Falls, LLC

  • Long Term Care Pharmacy
  • Ballston Spa, NY
National Provider Identifier
1891897096
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
014385 Issued in NY
Legal business name
PHARMACY ASSOCIATES OF GLENS FALLS, LLC
Doing business as
Omnicare of Ballston Spa
Omnicare of Ballston Spa #48309
Practice address
14 Commerce Dr
Ballston Spa, NY 12020-3631
Phone
(518) 899-2002
Fax
(888) 912-1668
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Susan Colbert
Title
Sr Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 014385 NY Primary

Addresses

Primary practice location

14 Commerce Dr
Ballston Spa, NY 12020-3631

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other names 2

  • Omnicare of Ballston Spa Doing business as
  • Omnicare of Ballston Spa #48309 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930062288 NY DME Supplier - Pharmacy 9638297872 Practice locations: Ballston Spa, NY
O20231129000320 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9638297872 Practice locations: Ballston Spa, 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
Omnicare of Ballston Spa14 Commerce Dr, Ballston Spa, NY 12020-3631(518) 899-2002 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 2009

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14 Commerce Dr
Ballston Spa, NY 12020
Phone (518) 899-2002

Practitioners & affiliated clinicians

Practitioners 7

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": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1891897096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 COMMERCE DR",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203631",
            "telephone_number": "518-899-2002",
            "fax_number": "888-912-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY ASSOCIATES OF GLENS FALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "014385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omnicare of Ballston Spa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omnicare of Ballston Spa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omnicare of Ballston Spa #48309",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.