Active NPI
Vince'S Pharmacy of Camillus Inc
- Long Term Care Pharmacy
- Camillus, NY
National Provider Identifier
1962129247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- VINCE'S PHARMACY OF CAMILLUS INC
- Practice address
- 240 Township Blvd Ste 30
Camillus, NY 13031-1793 - Phone
- (315) 487-5775
- Fax
- (315) 487-4423
- NPI assigned
- Oct 26, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Machen, PHARMD
- Title
- President
- Phone
- (315) 487-5775
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
240 Township Blvd Ste 30
Camillus, NY 13031-1793
Mailing address
240 Township Blvd Ste 30
Camillus, NY 13031-1793
Phone (315) 487-5775
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018681 | Other | NY | NYS |
| 0719740001 | Other | NY | MEDICARE |
| 00905748 | Medicaid | NY |
Other names 1
- Medicine Shoppe LTC
National Provider Directory
National Provider DirectoryLocations
240 Township Blvd
Ste 30
Camillus, NY 13031
Phone (315) 487-5775
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Camillus, NY
- NPI 1497036875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1962129247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 TOWNSHIP BLVD STE 30",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130311793",
"telephone_number": "315-487-5775",
"fax_number": "315-487-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 TOWNSHIP BLVD STE 30",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130311793",
"telephone_number": "315-487-5775",
"fax_number": "315-487-4423"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VINCE'S PHARMACY OF CAMILLUS INC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-26",
"last_updated": "2023-03-07",
"certification_date": "2022-12-14",
"status": "A",
"authorized_official_last_name": "MACHEN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "315-487-5775",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS",
"identifier": "018681",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "0719740001",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00905748",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medicine Shoppe LTC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Camillus, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.