Northside Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

023754 Issued in NY

Legal business name

NORTHSIDE PHARMACY CORP

Practice address

559 Driggs Ave
Brooklyn, NY 11211-2911

Phone

(718) 387-6566

Fax

(718) 782-7101

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Halina Josephine Jankowski, RPHNPI 1760776389

Title

RPH

Phone

(718) 387-6566

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NORTHSIDE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

Practitioners 2

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

• Halina Josephine Jankowski, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1760776389
  NPD Authorized official
• Rachel Parker, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1174810329
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1922034644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 DRIGGS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112112911",
            "telephone_number": "718-387-6566",
            "fax_number": "718-782-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 DRIGGS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112112911",
            "telephone_number": "718-387-6566",
            "fax_number": "718-782-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-09-13",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "JANKOWSKI",
        "authorized_official_first_name": "HALINA",
        "authorized_official_middle_name": "JOSEPHINE",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "718-387-6566",
        "authorized_official_credential": "RPH"
    },
    "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": "023754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01858497",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065344",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHSIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTHSIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northernstar Youth Initiative
• Northland Hearing Center, Inc.
• Nicole Sonia Northover, MD
• Northside BK LLC
• Northside Medical Care LLP
• Northside Psychology PLLC
• Northstar Medical PLLC
• Northstar Mental Health Counseling PLLC
• Andrea M Norton, M.D.
• Yola Alicia Norville Hamilton, LMSW

• 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 13, 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.