{"npi":"1336265396","type":"NPI-2","status":"active","name":{"display":"St George Pharmacy INC","other":[],"organization_name":"ST GEORGE PHARMACY INC","authorised_official":"Omar Mohamed"},"specialty":{"primary_taxonomy":"183500000X","primary_taxonomy_description":"Pharmacist","slug":"pharmacist","schema_org_specialty":null,"all":[{"code":"183500000X","description":"Pharmacist","primary":true,"state":"NY","license":"034093"}]},"addresses":[{"purpose":"LOCATION","street_1":"99 STUYVESANT PL","city":"STATEN ISLAND","state":"NY","postal_code":"103011917","country_code":"US","phone":"7184470333"},{"purpose":"MAILING","street_1":"99 STUYVESANT PL","city":"STATEN ISLAND","state":"NY","postal_code":"103011917","country_code":"US","phone":"7184470333"}],"license":{"state":"NY","number":"034093"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"02566301","state":"NY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20170822002815","type_code":"12-A5","type_desc":"PART B SUPPLIER - PHARMACY","state":"NY","pac_id":"4385916618"},{"enrlmt_id":"O20231017002174","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"NY","pac_id":"4385916618"}]},"enumeration_date":"2007-03-21","last_updated":"2023-04-04","_meta":{"source":"NPPES","snapshot_date":"2023-04-04","doc_url":"https://findmynpi.com/api"}}