Provider Demographics
NPI:1114565421
Name:DPR EQUITY INC
Entity Type:Organization
Organization Name:DPR EQUITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-292-8200
Mailing Address - Street 1:1987 STATE ROUTE 52 STE 3
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-8317
Mailing Address - Country:US
Mailing Address - Phone:845-292-8200
Mailing Address - Fax:
Practice Address - Street 1:1987 STATE ROUTE 52 STE 3
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-8317
Practice Address - Country:US
Practice Address - Phone:845-292-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03394754Medicaid