SRVN Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RI02587000 Issued in NJ

Legal business name

SRVN PHARMACY INC

Doing business as

Brockmans Pharmacy

Practice address

78 Avenue C
Bayonne, NJ 07002-2439

Phone

(201) 437-2175

Fax

(201) 437-4449

NPI assigned

Jul 18, 2006

Last updated

Mar 15, 2022By 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

Mr. Rathna Veeramachanani

Title

Pic

Phone

(201) 437-2175

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BROCKMANS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

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.

• Smitha Dasari

  • Pharmacist
  • New York, NY
  • NPI 1700059136
  NPD
• Herman Brockman

  • Pharmacist
  • Bayonne, NJ
  • NPI 1659696698
  NPD (past)
• Caroline Victor Ibrahim

  • Pharmacist
  • Bayonne, NJ
  • NPI 1669023339
  NPD (past)
• Dana Khalil

  • Pharmacist
  • Bayonne, NJ
  • NPI 1396390225
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1962420612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 AVENUE C",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022439",
            "telephone_number": "201-437-2175",
            "fax_number": "201-437-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 AVENUE C",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022439",
            "telephone_number": "201-437-2175",
            "fax_number": "201-437-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRVN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "VEERAMACHANANI",
        "authorized_official_first_name": "RATHNA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "201-437-2175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RI02587000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROCKMANS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BROCKMANS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.