OPTUM PHARMACY 706, INC. (NPI# 1295842615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295842615 |
| Entity Type | Organization |
| Organization Name | OPTUM PHARMACY 706, INC. |
| Practice Address |
3030 47th Ave Ste 410 Long Island City NY 11101-3433 |
| Mailing Address |
Po Box 851378 Minneapolis MN 55485-1378 |
| Practice Telephone | 8669034466 |
| Practice Fax Number | 7183910777 |
| Mailing Telephone | 8555776521 |
| Mailing Fax Number | 8122858541 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | DAVID JOHN OBERG (VICE PRESIDENT, COMPLIANCE) |
| Authorized Official Telephone | 9499885893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
026617 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0103128 | 05 | |
| NY | RESIDENT STATE PHARMACY LICENSE | 026617 | 01 |
| PK | 2062802 | 01 | |
| NY | 2577113 | 05 |
| Other Name | Type Code |
|---|---|
| BriovaRx | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | OPTUM PHARMACY 706, INC. | 1600 Mcconnor Pkwy., Schaumburg, IL 60173 |
| New York State Corporations | OPTUM PHARMACY 706, INC. | 28 Liberty Street, New York, Ny 10005 |
| Street Address |
3030 47TH AVE STE 410 |
| City | LONG ISLAND CITY |
| State | NY |
| Zip Code | 11101-3433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453469 | Marguerite Reilly | Speech-Language Pathologist | P721q John F. Kennedy School @ Information Technology H, 21-16 44th Road, Long Island City, NY 11101 | 2020-09-23 |
| 1831716323 | South Occupational Therapy Services, P.C. | Occupational Therapist | 1-50 50th Avenue, Apt 3806, Long Island City, NY 11101 | 2020-06-30 |
| 1104465392 | Cindy Ha | Nurse Practitioner | 29-22 Northern Blvd, Apt 1805, Long Island City, NY 11101 | 2020-01-06 |
| 1114565991 | Maria Montes | Counselor | 3110 37th Ave, Ste 401, Long Island City, NY 11101 | 2019-12-12 |
| 1235770777 | City Medical of Upper East Side, Pllc | Clinic/Center | 25-18 Queens Plaza South, Long Island City, NY 11101 | 2019-10-07 |
| 1073162343 | Kofi Robertson Md Pllc | Anesthesiology | 28-10 Jackson Avenue, Long Island City, NY 11101 | 2019-09-09 |
| 1689221368 | Crossland Transportation Management Corp | Non-emergency Medical Transport (VAN) | 34-18 Northern Blvd, Floor 4 Unit 32, Long Island City, NY 11101 | 2019-08-19 |
| 1295396190 | Natasha Fortune | Counselor | 3418 Northern Blvd Fl 4, Long Island City, NY 11101 | 2019-06-23 |
| 1588224901 | Lemon Health At Home, LLC | Home Health | 4628 Vernon Blvd., Suite 531, Long Island City, NY 11101 | 2019-06-18 |
| 1790342541 | Hospital Wood Medical Center | General Acute Care Hospital | Coxen Hole, Main Street, Roatan, BAY ISLANDS 11101 | 2019-05-28 |
| Find all providers in zip 11101 | ||||
| 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 |
|---|---|---|---|---|
| 1598388068 | Sunnyside Chemists Inc | Pharmacy | 3929 47th Ave, Long Island City, NY 11104-4407 | 2020-05-19 |
| 1114495256 | Nyco Chemists V Inc | Pharmacy | 25-29 44th Drive, Long Island City, NY 11101 | 2018-11-07 |
| 1104096213 | Amin Pharmacy Inc | Pharmacy | 29 03 36th Ave, Long Island City, NY 11106 | 2008-03-04 |
| 1275684748 | Queensbridge Plaza Pharmacy Corp | Pharmacy | 1037 41st Ave, Long Island City, NY 11101-7346 | 2007-01-13 |
| 1255426839 | Greenpoint Pharmacy Corporation | Pharmacy | 40-26 Greenpoint Avenue, Long Island City, NY 11104 | 2006-10-03 |
| 1013016344 | Genovese Drug Stores Inc | Pharmacy | 3099 Steinway St, Long Island City, NY 11103-3801 | 2006-09-22 |
| 1487753711 | Genovese Drug Stores Inc | Pharmacy | 3109 Ditmars Blvd, Long Island City, NY 11105-2304 | 2006-09-22 |
| 1245340868 | Costco Wholesale Corporation | Pharmacy | 32 50 Vernon Blvd, Long Island City, NY 11106 | 2006-08-30 |
| 1023023108 | Walgreen Eastern Co Inc | Pharmacy | 3355 Crescent St # 67, Long Island City, NY 11106-3809 | 2006-07-29 |
| 1831734334 | Greenleaf Chemists Inc | Pharmacy | 4202 Greenpoint Ave, Long Island City, NY 11104 | 2019-11-08 |
| Find all providers in LONG ISLAND CITY | ||||
| City | LONG ISLAND CITY |
| Zip Code | 11101 |
Please comment or provide details below to improve the information on OPTUM PHARMACY 706, INC..
| 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.