OrganizationActiveAccepts Medicare
4th Ave Drug Store Inc
NPI 1295299535 · Community/Retail Pharmacy · Mount Vernon, NY
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1295299535
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Bibi Esahack, President(914) 863-0399
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 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
26 S 4th Ave
Mount Vernon, NY 10550-3105
Phone: (914) 863-0399
Fax: (914) 863-0397
Street-level locationGet directions
Mailing address
26 S 4th Ave
Mount Vernon, NY 10550-3105
Registry dates
- Enumerated
- 2019-01-30
- Last updated
- 2020-06-08
- Certified
- 2020-06-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.