CRYSTAL CITY APOTHECARY LLC
NPI 1790566305
Pharmacy - Long Term Care Pharmacy in Waverly, NY

NPI Status: Active since October 10, 2023

Contact Information

443 CAYUTA AVE
WAVERLY, NY
ZIP 14892
Phone: (607) 565-2390
Fax: (607) 565-2393

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  • Organization
  • Pharmacy
  • Long Term Care Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Does Not Accept Medicare Approved Payment

About CRYSTAL CITY APOTHECARY LLC

This page provides the complete NPI Profile along with additional information for Crystal City Apothecary Llc, a provider established in Waverly, New York operating as a Pharmacy, focusing in long term care pharmacy . The healthcare provider is registered in the NPI registry with number 1790566305 assigned on October 2023. The practitioner's primary taxonomy code is 3336L0003X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Mr. Donald W Guthrie Robert Packer Hospital Rph (Member)

NPI
1790566305
Provider Name
CRYSTAL CITY APOTHECARY LLC
Entity Type
Organization
Location Address
443 CAYUTA AVE WAVERLY, NY 14892
Location Phone
(607) 565-2390
Location Fax
(607) 565-2393
Mailing Address
443 CAYUTA AVE WAVERLY, NY 14892
Mailing Phone
(607) 565-2390
Mailing Fax
(607) 565-2393
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-10-2023
Last Update Date
10-10-2023
Code Navigator



Crystal City Apothecary Llc is a medicare supplier with PTAN 20578289 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Epoetin or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Walkers or Orthoses: Off-The-Shelf or Ostomy Supplies or Urological Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Surgical Dressings.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Long Term Care Pharmacy

Taxonomy Code
3336L0003X
Type
Suppliers
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • ConnectPlus $0 Gold - PPO
  • ConnectPlus $0 Silver - PPO
  • ConnectPlus $10,600 HSA Eligible HDHP - PPO
  • ConnectPlus $1800 - PPO
  • ConnectPlus $4500 - PPO
  • ConnectPlus $6500 HSA Eligible HDHP - PPO
  • ConnectPlus $7500 HSA Eligible HDHP - PPO
  • ConnectPlus MyWeighForward $2000 - PPO
  • ConnectPlus MyWeighForward $6000 - PPO
  • ConnectPlus Standard $2000 - PPO
  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • Blue KC Catastrophic BlueSelect EPO - EPO
  • Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
  • Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
  • Blue KC Community Silver Preferred-Care Blue EPO - EPO
  • Blue KC First Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Simply Blue Bronze with Spira Care Blue Metro EPO - EPO
  • Blue KC Simply Blue Gold with Spira Care Blue Metro EPO - EPO
  • Blue KC Simply Blue Silver with Spira Care Blue Metro EPO - EPO
  • Blue KC Standard Bronze BlueSelect EPO - EPO
  • Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $10,600 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,500 - PPO
  • Sanford Individual Simplicity $7,200 HSA Qualified - PPO
  • Sanford Individual Simplicity Standardized $2,000 - PPO
  • Sanford Individual Simplicity Standardized $6,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • Sanford Individual TRUE $1,750 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DONALD W GUTHRIE ROBERT PACKER HOSPITAL RPH

Authorized Official Title
MEMBER
Authorized Official Phone
(160) 756-5239

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20578289
Accepts Medicare Assignment
NO
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790566305, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
3
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 5 → 10 → 1 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 0 + 6 + 1 + 2 + 3 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1790566305.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Pharmacy (Community/Retail Pharmacy)
443 CAYUTA AVE
WAVERLY, NY 14892

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790566305, enumerated as an "organization" on October 10, 2023.

The provider is located at 443 CAYUTA AVE WAVERLY, NY 14892 and the phone number is (607) 565-2390.

Pharmacy with taxonomy code 3336L0003X and a focus in Long Term Care Pharmacy.

The provider might be accepting Accepts: Antidote Health Plan of Arizona, Inc., Antidote. Please consult your insurance carrier or call the provider to verify.