PORT EWEN RX INC (NPI# 1821426321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821426321 |
| Entity Type | Organization |
| Organization Name | PORT EWEN RX INC |
| Other Organization Name | PORT EWEN PHARMACY |
| Practice Address |
177 Broadway Port Ewen NY 12466-7719 |
| Mailing Address |
Po Box 759 Port Ewen NY 12466-0759 |
| Practice Telephone | 8453314229 |
| Practice Fax Number | 8453404593 |
| Mailing Telephone | 8453314229 |
| Mailing Fax Number | 8453404593 |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | MR. VINAY ADUSUMILLI (MANAGER) |
| Authorized Official Telephone | 4402812324 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
032682 | NY | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2147379 | 01 |
| Other Name | Type Code |
|---|---|
| PORT EWEN PHARMACY | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PORT EWEN RX INC. | 177 Broadway Street, Port Ewen, Ny 12466 |
| Street Address |
177 BROADWAY |
| City | PORT EWEN |
| State | NY |
| Zip Code | 12466-7719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548322308 | Port Ewen Pharmacy Inc | Pharmacy | 177 Broadway, Port Ewen, NY 12466-7719 | 2006-12-15 |
| 1184104754 | Raghu Thota | Pharmacist | 177 Broadway, Port Ewen, NY 12466-7719 | 2018-08-14 |
| 1174840938 | Albert L. Didonna | Pharmacist | 177 Broadway, Port Ewen, NY 12466 | 2010-05-03 |
| 1891019592 | Dana Mary Schechter | Pharmacist | 177 Broadway, Port Ewen, NY 12466-0759 | 2010-03-24 |
| 1851615678 | Barbara Ann Price | Pharmacist | 177 Broadway, Port Ewen, NY 12466-0759 | 2010-03-23 |
| 1831413970 | Leigh Ellen Hill | Pharmacist | 177 Broadway, Port Ewen, NY 12466 | 2010-03-18 |
| 1720244221 | Helena Ann Marchetti | Pharmacist | 177 Broadway, Port Ewen, NY 12466 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316473689 | Jacinta Vondell | Registered Nurse | 158 Minturn Street, Port Ewen, NY 12466 | 2017-05-05 |
| 1861946154 | Tractorhealthsolutions LLC | Counselor | 243 Bayard Street, # 724, Port Ewen, NY 12466 | 2016-08-04 |
| 1023458296 | Leah Elizabeth Gherardi | Student in an Organized Health Care Education/Training Program | 163 Salem Street, Port Ewen, NY 12466 | 2013-07-02 |
| 1033452982 | William Latimer | Social Worker | 243 Bayard Street Box #724, Port Ewen, NY 12466 | 2013-03-28 |
| 1497023626 | Jennifer Andrea Petruski | Speech-Language Pathologist | 345 Mountain View Ave, Port Ewen, NY 12466 | 2011-12-02 |
| 1164676003 | Lori D Schwark | Occupational Therapist | 232 Bowne St., Port Ewen, NY 12466 | 2008-11-05 |
| 1194092171 | Lisa Piccolo | Physical Therapist | 319 Broadway, Ulster Boces Alternative Education, Port Ewen, NY 12466 | 2011-11-19 |
| 1780841247 | Stephen A Kleinman | Dentist | 186 Broadway, Port Ewen, NY 12466 | 2008-05-21 |
| 1154512655 | Dentist 4 U | Dentist | 186 Broadway, Port Ewen, NY 12466 | 2007-08-08 |
| 1669555439 | Franc John Libihoul | Social Worker | 319 Broadway, Port Ewen, NY 12466 | 2006-10-23 |
| Find all providers in zip 12466 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1548322308 | Port Ewen Pharmacy Inc | Pharmacy | 177 Broadway, Port Ewen, NY 12466-7719 | 2006-12-15 |
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|---|---|---|---|---|
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| 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.