Southbridge Pharmacy Inc
NPI 1134963291 · Community/Retail Pharmacy · New York, NY
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southbridge Pharmacy Inc is a Community/Retail Pharmacy organization in New York, NY (NPI 1134963291).
Provider details
- NPI number
- 1134963291
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Violetta Fazylova, President/Pharmacist/Authorized Off(212) 786-5840
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Southbridge Pharmacy Inc
Registry dates
- Enumerated
- 2024-06-24
- Last updated
- 2024-06-26
- Certified
- 2024-06-26
Frequently asked questions
- What is Southbridge Pharmacy Inc's NPI number?
- Southbridge Pharmacy Inc's National Provider Identifier (NPI) is 1134963291, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southbridge Pharmacy Inc?
- Southbridge Pharmacy Inc is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Southbridge Pharmacy Inc located?
- Southbridge Pharmacy Inc's practice location on file with NPPES is 80 Beekman St, New York, NY 10038-1891.
- What is Southbridge Pharmacy Inc's phone number?
- The practice phone number listed in the NPPES registry for Southbridge Pharmacy Inc is (212) 786-5840.
- Does Southbridge Pharmacy Inc accept Medicare?
- Southbridge Pharmacy Inc 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 Southbridge Pharmacy Inc?
- The authorized official listed on Southbridge Pharmacy Inc's NPPES record is Violetta Fazylova, President/Pharmacist/Authorized Off. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southbridge Pharmacy Inc's NPI active?
- Yes — Southbridge Pharmacy Inc's NPI (1134963291) is active in the NPPES registry as of the last update on 2024-06-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.