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NPI Code Detail

MEDICARE: BLOSSOMRX INC.

MEDICARE: BLOSSOMRX INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1538010749
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOSSOMRX INC.
Provider Business Mailing Address
First Line : 1660 RICHMOND RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-2322
Country : US
Telephone Number : 646-814-7755
Fax Number : 646-558-4890
Provider Business Practice Location Address
First Line : 1660 RICHMOND RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-2322
Country : US
Telephone Number : 646-814-7755
Fax Number : 646-558-4890
Authorized Official
Title or Position : PRESIDENT
Name : MARIANNA PEPE
Credential :
Telephone Number : 646-814-7755
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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