Organization Active NPI

East Main Street Chemists Inc

Doing business as Neighborx Pharmacy at Ormc

  • Community/Retail Pharmacy
  • Middletown, NY
National Provider Identifier
1912451030
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
035020 Issued in NY
Legal business name
EAST MAIN STREET CHEMISTS INC
Doing business as
Neighborx Pharmacy at Ormc
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-7250
Fax
(845) 333-7249
NPI assigned
Aug 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Jahan KeivanjahNPI 1750730099
Title
Owner
Phone
(845) 333-7250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 035020 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7250

Other identifiers 4

IdentifierTypeStateIssuer
035020OtherNYBOARD OF PHARMACY
5818274OtherNYNCPDP
A100162959OtherNYMEDICARE - NSC - MASS IMMUNIZATION
2162457OtherPK

Other names 1

  • NEIGHBORX PHARMACY AT ORMC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20170213001103 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1254614589 Practice locations: Middletown, NY
O20170421000228 NY DME Supplier - Pharmacy 1254614589 Practice locations: Middletown, NY
O20210105001365 NY Part B Supplier - Pharmacy 1254614589 Practice locations: Middletown, NY

National Provider Directory

National Provider Directory
Tax ID family
East Main Street Chemists Inc2 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1912451030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7250",
            "fax_number": "845-333-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7250",
            "fax_number": "845-333-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MAIN STREET CHEMISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "KEIVANJAH",
        "authorized_official_first_name": "JAHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-333-7250"
    },
    "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": "035020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "035020",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5818274",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - NSC - MASS IMMUNIZATION",
            "identifier": "A100162959",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEIGHBORX PHARMACY AT ORMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NEIGHBORX PHARMACY AT ORMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.