Provider Demographics
NPI:1003297854
Name:MDS CAPITAL LLC
Entity Type:Organization
Organization Name:MDS CAPITAL LLC
Other - Org Name:MDS CAPITAL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BUSCAINO
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PHARMACIST
Authorized Official - Phone:631-750-9088
Mailing Address - Street 1:140 KEYLAND CT UNIT 27
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2655
Mailing Address - Country:US
Mailing Address - Phone:631-750-9088
Mailing Address - Fax:631-250-9087
Practice Address - Street 1:140 KEYLAND CT UNIT 27
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2655
Practice Address - Country:US
Practice Address - Phone:631-750-9088
Practice Address - Fax:631-250-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 333600000X, 3336S0011X
NY0337893336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157920OtherPK