Provider Demographics
NPI:1003962291
Name:SMS PHARMACY CORP.
Entity Type:Organization
Organization Name:SMS PHARMACY CORP.
Other - Org Name:JORGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-567-2753
Mailing Address - Street 1:101 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5626
Mailing Address - Country:US
Mailing Address - Phone:212-567-2753
Mailing Address - Fax:
Practice Address - Street 1:101 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5626
Practice Address - Country:US
Practice Address - Phone:212-567-2753
Practice Address - Fax:212-942-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022261333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3365156OtherNCPDP
NY01525277Medicaid
NY3365156OtherNCPDP