CRYSTAL RUN PHARMACY LLC (NPI# 1053414532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053414532 |
| Entity Type | Organization |
| Organization Name | CRYSTAL RUN PHARMACY LLC |
| Other Organization Name | CRYSTAL RUN PHARMACY |
| Practice Address |
731 Route 211 E Ste 108 Middletown NY 10941-1457 |
| Practice Telephone | (845) 692-7628 |
| Practice Fax Number | 8456927644 |
| Mailing Telephone | (845) 692-7628 |
| Mailing Fax Number | 8456927644 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | SANDRA AGNELLO (PHARMACIST IN CHARGE) |
| Authorized Official Telephone | 8458636750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
027541 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 2814744 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3352084 | 01 | |
| NPI | 1053414532 | 01 |
| Other Name | Type Code |
|---|---|
| CRYSTAL RUN PHARMACY | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 390 Crystal Run Rd, Ste 111, Middletown, NY 109414050 | 8456927628 | 8456927644 |
| Street Address |
731 ROUTE 211 E STE 108 |
| City | MIDDLETOWN |
| State | NY |
| Zip Code | 10941-1457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471428 | Jackeline Montoya | Case Manager/Care Coordinator | 13 Kensington Manor, Middletown, NY 10941 | 2020-06-15 |
| 1124502398 | Kimberly Dominique Mccormick | Licensed Practical Nurse | 29, Macintosh Drive, Middletown, NY 10941 | 2018-09-24 |
| 1750891081 | Heather Skinner | Case Manager/Care Coordinator | 75 Crystal Run Rd Suite 201, Middletown, NY 10941 | 2017-09-29 |
| 1295281012 | Christa Lloyd | Counselor | 15 Fortune Rd, West Middletown, NY 10941 | 2016-08-31 |
| 1023471109 | Lauren Battaglia | Occupational Therapy Assistant | 192 Tower Drive Suite 400, Middletown, NY 10941 | 2016-04-05 |
| 1992188718 | Brynn Sierra | Occupational Therapist | 21 Riverside Drive, Middletown, NY 10941 | 2015-06-30 |
| 1356788574 | Keren Denis Joseph | Custodial Care Facility | 16 Disco Dr, Middletown, NY 10941 | 2013-05-29 |
| 1902169204 | Susan A. Reilly | Specialist | 2277 Gosen Turnpike, Middletown, NY 10941 | 2012-06-21 |
| 1518229392 | Dena Sapp | Case Manager/Care Coordinator | 75 Crystal Run Rd. Suite 201, Middletown, NY 10941 | 2012-06-08 |
| 1770800542 | Orange County Medical Transportation Inc. | Taxi | 80 Wisner Avenue, Middletown, NY 10941 | 2010-05-03 |
| Find all providers in zip 10941 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700434214 | Kratzer Pharmacy Inc. | Pharmacy | 711 S Breiel Blvd, Middletown, OH 45044-6201 | 2019-08-28 |
| 1962928473 | Walgreen Co | Pharmacy | 1447 State Route 35, Middletown, NJ 07748-2030 | 2017-08-16 |
| 1407179476 | Beena 3 Inc | Pharmacy | 167-171 Dolson Ave, Middletown, NY 10940 | 2010-03-05 |
| 1639404775 | Med One Pharmacy Inc | Pharmacy | 4317 Old National Pike, Middletown, MD 21769-7700 | 2009-10-07 |
| 1629268875 | Shoprite Supermarkets Inc. | Pharmacy | 20 Lloyds Lane, Middletown, NY 10940 | 2007-07-25 |
| 1962506766 | Rhode Island Cvs Pharmacy, L.L.C. | Pharmacy | 99 E Main Rd, Middletown, RI 02842-4953 | 2006-09-12 |
| 1396848016 | Hook Superx LLC | Pharmacy | 1006 W Mill St, Middletown, IN 47356-9353 | 2006-09-07 |
| 1285737007 | Ohio Cvs Stores LLC | Pharmacy | 820 S Breiel Blvd, Middletown, OH 45044-6204 | 2006-09-07 |
| 1477656296 | Ohio Cvs Stores LLC | Pharmacy | 2424 N Verity Pkwy, Middletown, OH 45042-2466 | 2006-09-07 |
| 1669575171 | Ohio Cvs Stores LLC | Pharmacy | 440 Oxford State Rd, Middletown, OH 45044-7434 | 2006-09-07 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 10941 |
Please comment or provide details below to improve the information on CRYSTAL RUN PHARMACY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.