Provider Demographics
NPI:1164425336
Name:BIOSCRIP PHARMACY(NY), INC
Entity Type:Organization
Organization Name:BIOSCRIP PHARMACY(NY), INC
Other - Org Name:BIOSCRIP INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:1600 BROADWAY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202
Mailing Address - Country:US
Mailing Address - Phone:720-697-5171
Mailing Address - Fax:
Practice Address - Street 1:1 VERMONT DR.
Practice Address - Street 2:
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:877-501-0108
Practice Address - Fax:516-355-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251F00000X, 332B00000X, 332BP3500X, 3336C0004X, 3336H0001X, 3336M0002X, 3336S0011X
NY028120333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPH01478OtherLICENSE
CT003095199Medicaid
NJ6754210Medicaid
DEA9-0000425OtherLICENSE
MEMO40001165OtherLICENSE
RIPHN10000OtherLICENSE
OH021198900OtherLICENSE
NY021820OtherLICENSE
SC10483OtherLICENSE
NHNR0135OtherLICENSE
VT1009850Medicaid
MO2004020573OtherLICENSE
NJ6754201Medicaid
HIPMP-237OtherLICENSE
PA1009850Medicaid
NJ28RO00023400OtherLICENSE
IN64000309AOtherLICENSE
CTPCN.0000299OtherLICENSE
FL17218OtherLICENSE
NY02244640Medicaid
NJ6754201Medicaid