Provider Demographics
NPI:1003419334
Name:CENTRAL PHARMACY LLC
Entity Type:Organization
Organization Name:CENTRAL PHARMACY LLC
Other - Org Name:CENTRAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:630-242-8969
Mailing Address - Street 1:121 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-2993
Mailing Address - Country:US
Mailing Address - Phone:929-397-0331
Mailing Address - Fax:929-397-0332
Practice Address - Street 1:121 KENT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-2993
Practice Address - Country:US
Practice Address - Phone:929-397-0331
Practice Address - Fax:929-397-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy