Elm Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

022262 Issued in NY

Legal business name

ELM PHARMACY, INC.

Practice address

1651 Coney Island Ave
Brooklyn, NY 11230-5849

Phone

(718) 336-8300

Fax

(718) 336-8421

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Leib Gershkovich, R.PH.NPI 1376712984

Title

President

Phone

(718) 336-8300

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Elm Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Elm Pharmacy2 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.

• Elm Pharmacy, Inc.

  • Long Term Care Pharmacy
  • Brooklyn, NY
  • NPI 1538977590
  NPD tax ID

Locations

Practitioners 1

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

• Leib Gershkovich, R.PH.

  • Pharmacist
  • Brooklyn, NY
  • NPI 1376712984
  NPD Authorized official

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902897259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "718-336-8300",
            "fax_number": "718-336-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "718-336-8300",
            "fax_number": "718-336-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERSHKOVICH",
        "authorized_official_first_name": "LEIB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-336-8300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "022262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01633985",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD DME PROVIDER #",
            "identifier": "A1298567",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP    OR   NCPDP",
            "identifier": "3369988",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.