Glen Cove Pharm LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025220 Issued in NY

Legal business name

GLEN COVE PHARM LLC

Doing business as

Glen Cove Chemists

Practice address

20 Forest Ave
Glen Cove, NY 11542-2106

Phone

(516) 676-9111

Fax

(516) 676-5162

NPI assigned

Mar 22, 2007

Last updated

Oct 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohan Jolly, RPHNPI 1841393204

Title

Owner

Phone

(516) 676-9111

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• GLEN COVE CHEMISTS Doing business as

Locations

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.

• Mohan J Jolly, RPH

  • Pharmacist
  • Glen Cove, NY
  • NPI 1841393204
  NPD (past) Authorized official
• Lisa M. Acquista-Olivieri, RPH

  • Pharmacist
  • Glen Cove, NY
  • NPI 1689791667
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1932225620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422106",
            "telephone_number": "516-676-9111",
            "fax_number": "516-676-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422106",
            "telephone_number": "516-676-9111",
            "fax_number": "516-676-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN COVE PHARM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "JOLLY",
        "authorized_official_first_name": "MOHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-676-9111",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063681",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02205301",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLEN COVE CHEMISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Glen Cove Faculty Medical Affiliates, University Faculty Practice Corp
• Glen Cove Family Medicine. PLLC
• Glen Cove Hospital
• Glen Cove Hospital
• Glen Cove Hospital
• Glen Cove Physical Medicine, PC
• Glen Cove Physical Therapy, P.C.
• Glen Cove Podiatry, PLLC
• Glen Head Chiropractic & Physical Therapy, PLLC
• Glen Medical Health, PC

• Community/Retail Pharmacy in Glen Cove, NY
• Providers in Glen Cove, 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 24, 2014; 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.