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OLD TOWN PHARMACY, INC
NPI 1063574739
Pharmacy - Community/Retail Pharmacy in Staten Island, NY

Active since December 15, 2006
1250 HYLAN BLVD STE 3A, STATEN ISLAND, NY 10305(718) 815-2600(718) 815-2095 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 25, 2021, Apr 11, 2019, Jun 5, 2017 (3 updates tracked since 2017).

About Old Town Pharmacy, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLD TOWN PHARMACY, INC (NPI 1063574739) is a healthcare organization registered as a community/retail pharmacy in Staten Island, New York and active in the NPI registry since December 2006. The organization lists Inna Ichtchenko, Prsident, as its authorized official.

NPPES Registry Identity

NPI1063574739
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameOLD TOWN PHARMACY, INC
Location Address1250 HYLAN BLVD STE 3AStaten Island, NY 10305-1944
Mailing Address1250 Hylan BlvdStaten Island, NY 10305-1943 · (718) 815-2600 · Fax (718) 815-2095
Phone(718) 815-2600
Fax(718) 815-2095
Organization SubpartNo
Authorized OfficialInna IchtchenkoPrsident · (718) 815-2600
Enumeration DateDecember 15, 2006
Last NPPES UpdateAugust 31, 20213 updates tracked since enumeration
NPPES CertifiedAugust 31, 2021
✔ NPI 1063574739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
1250 HYLAN BLVD STE 3A, Staten Island, NY 10305
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Other Identifiers 1

Medicaid02664717NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old Town Pharmacy, Inc's NPI number?

The NPI number for Old Town Pharmacy, Inc is 1063574739. It was assigned to this organization in the NPPES registry on December 15, 2006.

Where is Old Town Pharmacy, Inc located?

Old Town Pharmacy, Inc is located at 1250 Hylan Blvd Ste 3A, Staten Island, NY 10305. The listed phone number is (718) 815-2600.

What is Old Town Pharmacy, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Old Town Pharmacy, Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 44 other insurers list Old Town Pharmacy, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Old Town Pharmacy, Inc was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.