CALJEB PHARMACY CORP (NPI# 1275536864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275536864 |
| Entity Type | Organization |
| Organization Name | CALJEB PHARMACY CORP |
| Other Organization Name | LIGHTHOUSE PHARMACY |
| Practice Address |
747 Montauk Highway Patchogue NY 11772 |
| Practice Telephone | 6316542444 |
| Practice Fax Number | 6316541837 |
| Mailing Telephone | 6316542444 |
| Mailing Fax Number | 6316541837 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2017-03-24 |
| Authorized Official Name | PATRICK FAWCETT (CEO) |
| Authorized Official Telephone | 6316542444 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
016177 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2060288 | 01 | |
| NY | 00628717 | 05 |
| Other Name | Type Code |
|---|---|
| LIGHTHOUSE PHARMACY | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CALJEB PHARMACY CORP. | 747 Montauk Highway, East Patchogue, New York 11772 |
| Street Address |
747 MONTAUK HIGHWAY |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| 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 |
|---|---|---|---|---|
| 1780781542 | Pathmark Stores Inc | Pharmacy | 399 Medford Ave, Patchogue, NY 11772-1849 | 2006-09-20 |
| 1861419483 | King Kullen Pharmacies Corp | Pharmacy | 440 E Sunrise Hwy, Patchogue, NY 11772-2254 | 2006-07-17 |
| 1093238891 | Walgreen Co | Pharmacy | 397 Sunrise Hwy W, Patchogue, NY 11772-1901 | 2017-07-24 |
| 1467817734 | King Kullen Pharmacies Corp. | Pharmacy | 440 E Sunrise Hwy, Patchogue, NY 11772-2254 | 2015-12-30 |
| 1841393675 | Cvs Albany LLC | Pharmacy | 503 E Main St, Patchogue, NY 11772-3107 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396388 | Sharx Corp | Pharmacy | 4301 48th Ave, Woodside, NY 11377-6241 | 2020-11-03 |
| 1841890878 | Corner Pharmacy Myrtle | Pharmacy | 680 Myrtle Ave, Brooklyn, NY 11205-4119 | 2020-10-28 |
| 1124627302 | Elite Pharmacy Inc. | Pharmacy | 614a Grand St, Brooklyn, NY 11211-4802 | 2020-10-20 |
| 1073111951 | Pharmacy On Bay Street Inc. | Pharmacy | 1209 Bay St, Staten Island, NY 10305-3121 | 2020-10-13 |
| 1760080741 | Carol Pharmacy LLC | Pharmacy | 4230 Broadway, New York, NY 10033-3746 | 2020-10-13 |
| 1528666443 | Mvp Pharmacy Inc | Pharmacy | 920 Wheeler Rd Ste 920, Hauppauge, NY 11788-2900 | 2020-10-13 |
| 1477151512 | 101 Rx Pharmacy Inc | Pharmacy | 101 Rx Pharmacy Inc, 9718 101st Ave, Ozone Park, NY 11416 | 2020-10-12 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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| 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.