ST JOHNLAND NURSING CENTER NPI 1447286174

NPI Information

NPI: 1447286174
Provider Name: ST JOHNLAND NURSING CENTER
Classification: Pharmacy - 333600000X
Entity Type: Organization
CLIA Number: 33D0654188
Address: 395 SUNKEN MEADOW RD
KINGS PARK, NY
ZIP 11754
Phone: (631) 269-5800

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NPI Details

ST JOHNLAND NURSING CENTER is a pharmacy in Kings Park, 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. ST JOHNLAND NURSING CENTER NPI is 1447286174. The provider is registered as an organization entity type.

The provider's business location address is:

395 SUNKEN MEADOW RD
KINGS PARK, NY
ZIP 11754-000
Phone: (631) 269-5800
Fax: (631) 269-5876

The provider's authorized official is Mary Jean Weber .
The authorized official title is Ceo Admin and has the following contact phone number (631) 269-5800.

The CLIA number assigned to this NPI record is 33D0654188 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 9/11/2025.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3336L0003X	Pharmacy	Long Term Care Pharmacy			No
2	333600000X	Pharmacy		5157311N	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00309393	MEDICAID	NEW YORK
2	3349328	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/21/2025

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