Organization Active NPI

Goodyear Four Boys Pharmacy Inc.

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1922160258
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021657 Issued in NY
Legal business name
GOODYEAR FOUR BOYS PHARMACY INC.
Practice address
2584 Coney Island Ave
Brooklyn, NY 11223-5028
Phone
(718) 375-3456
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey A. Appel, RPH
Title
President
Phone
(718) 375-3456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021657 NY Primary

Addresses

Primary practice location

2584 Coney Island Ave
Brooklyn, NY 11223-5028

Mailing address

2584 Coney Island Ave
Brooklyn, NY 11223-5028
Phone (718) 375-3456

Other identifiers 1

IdentifierTypeStateIssuer
01406188MedicaidNY

National Provider Directory

National Provider Directory

Locations

2584 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 375-3456

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922160258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235028",
            "telephone_number": "718-375-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235028",
            "telephone_number": "718-375-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODYEAR FOUR BOYS PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "APPEL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-375-3456",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "021657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01406188",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.