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CCRX OF NEW YORK LLC NPI 1417052846


NPI Information

NPI: 1417052846
Provider Name: CCRX OF NEW YORK, LLC

Doing Business As: MTM PHARMACY SERVICES

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
431 NEW KARNER RD
ALBANY, NY
ZIP 12205
Phone: (518) 862-2195
Get Directions

CCRX OF NEW YORK, LLC is a pharmacy in Albany, NY. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. CCRX OF NEW YORK, LLC NPI is 1417052846. The provider is registered as an organization entity type.
The provider Is Doing Business As Mtm Pharmacy Services.

The provider's business location address is:

431 NEW KARNER RD
ALBANY, NY
ZIP 12205-868
Phone: (518) 862-2195
Fax: (518) 862-2199

The provider's authorized official is Scott D Habecker .
The authorized official title is Secretary and has the following contact phone number (717) 810-1950.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 8/22/2020.


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
1333600000XPharmacy027847NEW 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
102749360MEDICAIDNEW YORK

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.