KING KULLEN PHARMACY (NPI# 1376691329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376691329 |
| Entity Type | Organization |
| Organization Name | KING KULLEN PHARMACY |
| Practice Address |
499 Sunrise Hwy Ste 64 Patchogue NY 11772-2290 |
| Mailing Address |
King Kullen Grocery Co Inc 185 Central Ave Dept 1030 Bethpage NY 11714-3929 |
| Practice Telephone | 6312890376 |
| Practice Fax Number | 6314478890 |
| Mailing Telephone | 5167337100 |
| Mailing Fax Number | 5168276263 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2009-02-24 |
| Authorized Official Name | ALBERT HESSE (PHARMACY COORDINATOR) |
| Authorized Official Telephone | 5167337100 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | KING KULLEN PHARMACY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
021207 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 3320215 | 01 | |
| NY | 01343571 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3320215 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154479111 | King Kullen Pharmacy | Pharmacy | 455 Park Ave, Lindenhurst, NY 11757-5250 | 2007-01-08 |
| 1538217591 | King Kullen Pharmacy | Pharmacy | 231 W Merrick Rd, Valley Stream, NY 11580-5514 | 2007-01-08 |
| 1245388206 | King Kullen Pharmacy | Pharmacy | 575 Nesconset Hwy, Hauppauge, NY 11788-2758 | 2007-01-08 |
| 1578611521 | King Kullen Pharmacy | Pharmacy | 795 Old Country Rd, Riverhead, NY 11901-2111 | 2007-01-08 |
| 1447308408 | King Kullen Pharmacy | Pharmacy | 120 Veterans Memorial Hwy, Commack, NY 11725-3432 | 2007-01-08 |
| 1093863045 | King Kullen Pharmacy | Pharmacy | 440 E Main St, Bay Shore, NY 11706-8501 | 2007-01-08 |
| Street Address |
499 SUNRISE HWY STE 64 |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-2290 |
| 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.