Crystal Run Pharmacy LLC
NPI 1053414532 · Community/Retail Pharmacy · Middletown, NY
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Crystal Run Pharmacy LLC is a Community/Retail Pharmacy organization in Middletown, NY (NPI 1053414532).
Provider details
- NPI number
- 1053414532
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Sandra Agnello, Pharmacist in Charge(845) 863-6750
- License
- 027541 (NY)
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
114 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 87 | $46 |
| Administration of Influenza Virus VaccineG0008 | 27 | $35 |
Typical Medicare-allowed amounts for these services range $35–$46 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Crystal Run Pharmacy
Additional practice locations (1)
- 390 Crystal Run RdSte 111Middletown, NY 10941-4050Phone: (845) 692-7628Fax: (845) 692-7644
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2024-02-02
- Certified
- 2024-02-02
Frequently asked questions
- What is Crystal Run Pharmacy LLC's NPI number?
- Crystal Run Pharmacy LLC's National Provider Identifier (NPI) is 1053414532, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crystal Run Pharmacy LLC?
- Crystal Run Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Crystal Run Pharmacy LLC located?
- Crystal Run Pharmacy LLC's practice location on file with NPPES is 731 Route 211 E Ste 108, Middletown, NY 10941-1457.
- What is Crystal Run Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Crystal Run Pharmacy LLC is (845) 692-7628.
- Does Crystal Run Pharmacy LLC accept Medicare?
- Crystal Run Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Crystal Run Pharmacy LLC?
- The authorized official listed on Crystal Run Pharmacy LLC's NPPES record is Sandra Agnello, Pharmacist in Charge. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crystal Run Pharmacy LLC's NPI active?
- Yes — Crystal Run Pharmacy LLC's NPI (1053414532) is active in the NPPES registry as of the last update on 2024-02-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.