Provider Demographics
NPI:1225496623
Name:BIO DRUG INC
Entity Type:Organization
Organization Name:BIO DRUG INC
Other - Org Name:CORDETTE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERIBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-398-9999
Mailing Address - Street 1:55 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3803
Mailing Address - Country:US
Mailing Address - Phone:212-398-9999
Mailing Address - Fax:212-719-5371
Practice Address - Street 1:55 W 39TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3803
Practice Address - Country:US
Practice Address - Phone:212-398-9999
Practice Address - Fax:212-719-5371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034390333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2159521OtherPK