4TH AVE DRUG STORE INC
NPI 1295299535
Pharmacy - Community/Retail Pharmacy in Mount Vernon, NY

Q: What is 4th Ave Drug Store Inc's NPI number?

The NPI number for 4th Ave Drug Store Inc is 1295299535. It was assigned to this organization in the NPPES registry on January 30, 2019.

Q: What is 4th Ave Drug Store Inc's specialty?

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

Active since January 30, 2019

26 S 4TH AVE, MOUNT VERNON, NY 10550(914) 863-0399(914) 863-0397 Get Directions Write a Review

NPPES record last updated: June 8, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 8, 2020, Jan 30, 2019 (2 updates tracked since 2019).

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About 4th Ave Drug Store Inc NPPES

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

4TH AVE DRUG STORE INC (NPI 1295299535) is a healthcare organization registered as a community/retail pharmacy in Mount Vernon, New York and active in the NPI registry since January 2019. The organization lists Bibi Esahack, President, as its authorized official.

NPPES Registry Identity

NPI1295299535

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business Name4TH AVE DRUG STORE INC

Location Address26 S 4TH AVEMount Vernon, NY 10550-3105

Mailing Address26 S 4th AveMount Vernon, NY 10550-3105 · (914) 863-0399 · Fax (914) 863-0397

Phone(914) 863-0399

Fax(914) 863-0397

Organization SubpartNo

Authorized OfficialBibi EsahackPresident · (914) 863-0399

Enumeration DateJanuary 30, 2019

Last NPPES UpdateJune 8, 20202 updates tracked since enumeration

NPPES CertifiedJune 8, 2020

✔ NPI 1295299535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedPharmacyTaxonomy 333600000X

26 S 4TH AVE, Mount Vernon, NY 10550

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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 Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

4th Ave Drug Store Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date 2

Next revalidation due by January 31, 2027

This provider holds 2 Medicare enrollments with upcoming revalidation dates. Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNew YorkEnrollment IDO20190710000075DME · PharmacyDue dateJanuary 31, 2027

StateNew YorkEnrollment IDO20220228001283Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUES HUGHES VILUS PHARMD

Pharmacist

26 S 4TH AVE
MOUNT VERNON, NY 10550

Westchester County (914) 863-0399

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 4th Ave Drug Store Inc's NPI number?

The NPI number for 4th Ave Drug Store Inc is 1295299535. It was assigned to this organization in the NPPES registry on January 30, 2019.

Where is 4th Ave Drug Store Inc located?

4th Ave Drug Store Inc is located at 26 S 4th Ave, Mount Vernon, NY 10550. The listed phone number is (914) 863-0399.

What is 4th Ave Drug Store Inc's specialty?

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

Is 4th Ave Drug Store Inc enrolled in Medicare?

Yes. 4th Ave Drug Store Inc is registered in the Medicare PECOS enrollment system.

When is 4th Ave Drug Store Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), 4th Ave Drug Store Inc holds 2 Medicare enrollments with upcoming revalidation dates. The next is due by January 31, 2027 (DME, New York, Pharmacy). Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does 4th Ave Drug Store Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 44 other insurers list 4th Ave Drug Store 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 4th Ave Drug Store Inc was last updated on June 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.