St Jude Pharmacy & Surgical Supp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030756 Issued in NY

Legal business name

ST JUDE PHARMACY & SURGICAL SUPP

Doing business as

ST JUDES PHCY AND SURG SPLY CORP

Practice address

121 Saint Nicholas Ave
Brooklyn, NY 11237-4043

Phone

(718) 381-5116

Fax

(718) 417-3621

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Mitchell Chervin

Title

Supervising Phcst

Phone

(718) 381-5116

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ST JUDES PHCY AND SURG SPLY CORP Doing business as

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1922178730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SAINT NICHOLAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374043",
            "telephone_number": "718-381-5116",
            "fax_number": "718-417-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SAINT NICHOLAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374043",
            "telephone_number": "718-381-5116",
            "fax_number": "718-417-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE PHARMACY & SURGICAL SUPP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "CHERVIN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "SUPERVISING PHCST",
        "authorized_official_telephone_number": "718-381-5116"
    },
    "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": "030756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01061563",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3391478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JUDES PHCY AND SURG SPLY CORP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria St John
• St John'S Episcopal Hospital
• St Johns Dental Care PC
• St Johns Place Pharmacy Inc
• Jean A St Joy
• St Jude'S Physical Therapy
• St Judes PT
• Fabie Johanne St Juste, RN
• St Karas Rehab Services Inc
• Carline St Louis, MD

• 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 Oct 3, 2011; 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.