Provider Demographics
NPI:1033623079
Name:ONEIDA PHARMACY LLC
Entity Type:Organization
Organization Name:ONEIDA PHARMACY LLC
Other - Org Name:THE MEDICINE SHOPPE #1341
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHISHEK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-647-5729
Mailing Address - Street 1:507 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1521
Mailing Address - Country:US
Mailing Address - Phone:315-363-1750
Mailing Address - Fax:315-361-1099
Practice Address - Street 1:507 LENOX AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1521
Practice Address - Country:US
Practice Address - Phone:315-363-1750
Practice Address - Fax:315-361-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0358373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5824796OtherNCPDP
5824796OtherNCPDP