NPIMap

Organization Active NPI

Keeseville Pharmacy Inc

  • Long Term Care Pharmacy
  • Keeseville, NY
National Provider Identifier
1932639937
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
017834 Issued in NY
Legal business name
KEESEVILLE PHARMACY INC
Doing business as
Keeseville Pharmacy, Inc
Practice address
1730 Front St
Keeseville, NY 12944-3618
Phone
(518) 834-6090
Fax
(518) 834-7021
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Daniel BosleyNPI 1881759819
Title
Pharmacist
Phone
(518) 834-6090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 017834 NY Primary

Addresses

Primary practice location

1730 Front St
Keeseville, NY 12944-3618

Mailing address

1730 Front St
Keeseville, NY 12944-3618
Phone (518) 834-6090

Other identifiers 2

IdentifierTypeStateIssuer
00775571MedicaidNY
2169937OtherPK

Other names 1

  • Keeseville Pharmacy, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

1730 Front St
Keeseville, NY 12944
Phone (518) 834-6090

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1932639937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 FRONT ST",
            "city": "KEESEVILLE",
            "state": "NY",
            "postal_code": "129443618",
            "telephone_number": "518-834-6090",
            "fax_number": "518-834-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 FRONT ST",
            "city": "KEESEVILLE",
            "state": "NY",
            "postal_code": "129443618",
            "telephone_number": "518-834-6090",
            "fax_number": "518-834-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEESEVILLE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "BOSLEY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "518-834-6090"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "017834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00775571",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2169937",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keeseville Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Keeseville Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keeseville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.