3890 Broadway Pharmacy IV, Inc.
NPI 1790766103ActiveOrganization· Pharmacy· New York, NY
Pharmacy in New York, New York, registered in NPPES in November 2005. The authorized official on file is Haydee Meregildo, Owner.
Overview
| NPI | 1790766103 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 11, 2005 |
| Last updated in NPPES | Sep 15, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 027458 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | Possible (name) | Excluded · since Aug 13, 2008 · NY |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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