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OLD ROSWELL HOLDINGS LLC
NPI 1356154843
Pharmacy - Long Term Care Pharmacy in Binghamton, NY

Active since January 29, 2025
1179 VESTAL AVE STE 1, BINGHAMTON, NY 13903(607) 723-7585(607) 773-0936 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Old Roswell Holdings Llc NPPES

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

OLD ROSWELL HOLDINGS LLC (NPI 1356154843), doing business as Medicine Shoppe 1517c, is a healthcare organization registered as a long term care pharmacy in Binghamton, New York and active in the NPI registry since January 2025. The organization lists Tracy Eden, Owner, as its authorized official.

NPPES Registry Identity

NPI1356154843
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameOLD ROSWELL HOLDINGS LLC
Location Address1179 VESTAL AVE STE 1Binghamton, NY 13903-1606
Mailing Address5064 Roswell RdAtlanta, GA 30342-2281 · (404) 459-8005 · Fax (404) 256-5517
Phone(607) 723-7585
Fax(607) 773-0936
Organization SubpartNo
Authorized OfficialTracy EdenOwner · (404) 459-8005
Enumeration DateJanuary 29, 2025
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1356154843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
1179 VESTAL AVE STE 1, Binghamton, NY 13903
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Other Names 1

Doing Business AsMedicine Shoppe 1517c

Other Providers at the Same Location NPPES 4

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

OLD ROSWELL HOLDINGS LLC
Pharmacy (Long Term Care Pharmacy)
1179 VESTAL AVE STE 1
BINGHAMTON, NY 13903
Broome County (607) 723-7585
NICOLAS FANTINI
Pharmacist
1179 VESTAL AVE STE 1
BINGHAMTON, NY 13903
Broome County (607) 723-7585
AVENELLE K JOHNSON RPH
Pharmacist
1179 VESTAL AVE STE 1
BINGHAMTON, NY 13903
Broome County (607) 723-7584
OLD ROSWELL HOLDINGS LLC
Pharmacy (Community/Retail Pharmacy)
1179 VESTAL AVE STE 1
BINGHAMTON, NY 13903
Broome County (607) 723-7585

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 Roswell Holdings LLC's NPI number?

The NPI number for Old Roswell Holdings LLC is 1356154843. It was assigned to this organization in the NPPES registry on January 29, 2025. The provider is doing business as Medicine Shoppe 1517C.

Where is Old Roswell Holdings LLC located?

Old Roswell Holdings LLC is located at 1179 Vestal Ave Ste 1, Binghamton, NY 13903. The listed phone number is (607) 723-7585.

What is Old Roswell Holdings LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

When was this NPI record last updated?

The NPPES record for Old Roswell Holdings LLC was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.