Organization Active NPI

Ethan Drug Corp

  • Community/Retail Pharmacy
  • Floral Park, NY
National Provider Identifier
1962629048
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
028336 Issued in NY
Legal business name
ETHAN DRUG CORP
Practice address
27268 Grand Central Pkwy
Floral Park, NY 11005-1342
Phone
(718) 631-9300
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Danny Askari, RPH
Title
Owner
Phone
(718) 631-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 028336 NY Primary

Addresses

Primary practice location

27268 Grand Central Pkwy
Floral Park, NY 11005-1342

Mailing address

27268 Grand Central Pkwy
Floral Park, NY 11005-1342
Phone (718) 631-9300

Other identifiers 1

IdentifierTypeStateIssuer
02861347MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930055635 NY DME Supplier - Pharmacy 9638374010 Practice locations: Floral Park, NY
O20160219001811 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9638374010 Practice locations: Floral Park, NY

National Provider Directory

National Provider Directory
Tax ID family
Ethan Drug Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

27268 Grand Central Pkwy
Floral Park, NY 11005
Phone (718) 631-9300

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1962629048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27268 GRAND CENTRAL PKWY",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110051342",
            "telephone_number": "718-631-9300",
            "fax_number": "718-747-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27268 GRAND CENTRAL PKWY",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110051342",
            "telephone_number": "718-631-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHAN DRUG CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "ASKARI",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-631-9300",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02861347",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.