Myrtle RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031019 Issued in NY

Legal business name

MYRTLE RX LLC

Practice address

1454 Myrtle Ave
Brooklyn, NY 11237-5102

Phone

(718) 453-6200

Fax

(718) 455-3226

NPI assigned

Aug 16, 2011

Organization subpart

No

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

Authorized official

Name

Pete Sutaria

Title

Member

Phone

(718) 453-6200

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Myrtle Drugs Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

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

Member of 1

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

• Dipna RX Inc

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1104933795

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yakov Fattakhov

  • Pharmacist
  • Brooklyn, NY
  • NPI 1972936979
  NPD (past)
• Howard S. Feder, R.PH.

  • Pharmacist
  • Brooklyn, NY
  • NPI 1427039676
  NPD (past)
• Adrian Vega

  • Pharmacist
  • Brooklyn, NY
  • NPI 1831465004
  NPD (past)

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1902185366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MYRTLE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375102",
            "telephone_number": "718-453-6200",
            "fax_number": "718-455-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MYRTLE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375102",
            "telephone_number": "718-453-6200",
            "fax_number": "718-455-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "SUTARIA",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-453-6200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "031019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03361300",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133119",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lyneley Myrthil
• Marie Sonia Myrtil
• Myrtle Ave Pharmacy Inc
• Myrtle Drug Care Corp
• Myrtle Pharmacy Inc
• Olga Myshkina
• Chaya Myski
• Yehudis H. Myski, M.S.
• Anastasiia Myslyk
• Navya Mohan Mysore, M.D.C.M.

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 Sep 22, 2016; 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.