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PEG APOTHECARY INC NPI 1770678666


NPI Information

NPI: 1770678666
Provider Name: PEG APOTHECARY INC

Doing Business As: EMERALD PHARMACY

Classification: Pharmacist - 183500000X
Entity Type: Organization

CLIA Number: 33D2208520

Address:
4295 KATONAH AVE
BRONX, NY
ZIP 10470
Phone: (718) 944-0862
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PEG APOTHECARY INC is a pharmacist in Bronx, NY. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. PEG APOTHECARY INC NPI is 1770678666. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Emerald Pharmacy.

The provider's business location address is:

4295 KATONAH AVE
BRONX, NY
ZIP 10470
Phone: (718) 944-0862
Fax: (718) 944-0864

The provider's authorized official is William Shawn Nealis .
The authorized official title is President and has the following contact phone number (718) 944-0862.

The CLIA number assigned to this NPI record is 33D2208520 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1183500000XPharmacist047516NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100290857MEDICAIDNEW YORK
2025341OTHERNEW YORKNYS PHARMACY LIC
33325835OTHERNEW YORKNABP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.