Provider Demographics
NPI:1093099038
Name:HUDSON VIEW PHARMACY, INC.
Entity Type:Organization
Organization Name:HUDSON VIEW PHARMACY, INC.
Other - Org Name:HUDSON VIEW PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-561-4370
Mailing Address - Street 1:147 LAKE ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5263
Mailing Address - Country:US
Mailing Address - Phone:845-561-4370
Mailing Address - Fax:845-561-4263
Practice Address - Street 1:147 LAKE ST
Practice Address - Street 2:STE 101
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5264
Practice Address - Country:US
Practice Address - Phone:845-561-4370
Practice Address - Fax:845-561-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0310573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03388727Medicaid
3315466OtherNCPDP IDENTIFICATION NUMBER