Sr Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027473 Issued in NY

Legal business name

SR PHARMACY INC

Practice address

4329 Broadway
New York, NY 10033-2408

Phone

(212) 740-8500

Fax

(212) 740-9400

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Srinivasa EdavalapatiNPI 1356665731

Title

Pharmacy Manager

Phone

(212) 740-8500

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BROADWAY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

Practitioners 1

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

• Srinivasa Rao Edavalapati, M.PHARM

  • Pharmacist
  • New York, NY
  • NPI 1356665731
  NPD Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1922049352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100332408",
            "telephone_number": "212-740-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4329 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100332408",
            "telephone_number": "212-740-8500",
            "fax_number": "212-740-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SR PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "EDAVALAPATI",
        "authorized_official_first_name": "SRINIVASA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "212-740-8500"
    },
    "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": "027473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066379",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2721093",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROADWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Jean Squires, LCSW
• James Jerome Squires, M.D.
• Jonathan Squires, MD
• Natalie A Squires, MD
• Stephanie Squittieri, AUD, CCC-A
• Sr Psychological Services P.C.
• Sravisht Iyer MD PC
• SRB Plastic Surgery PC
• Aditya Sreenivasan, M.D.
• Venkatesh Sreeram, MD

• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 Jan 17, 2017; 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.