Provider Demographics
NPI:1205841814
Name:GARFIELD PHARMACY OF MERRICK INC
Entity Type:Organization
Organization Name:GARFIELD PHARMACY OF MERRICK INC
Other - Org Name:GARFIELD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARUNAREKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENIGALLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:347-528-8893
Mailing Address - Street 1:1760 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2728
Mailing Address - Country:US
Mailing Address - Phone:516-378-5521
Mailing Address - Fax:516-378-6195
Practice Address - Street 1:1760 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2728
Practice Address - Country:US
Practice Address - Phone:516-378-5521
Practice Address - Fax:516-378-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0164043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2061469OtherPK
NY00383055Medicaid
5470590001Medicare NSC