Provider Demographics
NPI:1003833740
Name:PALMA PHARMACY LTD
Entity Type:Organization
Organization Name:PALMA PHARMACY LTD
Other - Org Name:DBA PALMA CHEMISTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMAIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNAMARIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MONTEFORTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-638-9617
Mailing Address - Street 1:159 - 7TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2202
Mailing Address - Country:US
Mailing Address - Phone:718-638-9617
Mailing Address - Fax:718-398-6631
Practice Address - Street 1:159 - 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2202
Practice Address - Country:US
Practice Address - Phone:718-638-9617
Practice Address - Fax:718-398-6631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0247723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00267092Medicaid
NY3326205OtherNABP