Provider Demographics
NPI:1225125628
Name:MT. CARMEL PHARMACY INC
Entity Type:Organization
Organization Name:MT. CARMEL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAGANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-364-6100
Mailing Address - Street 1:705 E 187TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-6803
Mailing Address - Country:US
Mailing Address - Phone:718-364-6100
Mailing Address - Fax:718-365-6421
Practice Address - Street 1:705 E 187TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6803
Practice Address - Country:US
Practice Address - Phone:718-364-6100
Practice Address - Fax:718-365-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20988333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01272962Medicaid
NY4123370001Medicare NSC