Provider Demographics
NPI:1235429523
Name:SILVER PHARMACY INC
Entity Type:Organization
Organization Name:SILVER PHARMACY INC
Other - Org Name:SILVER PHARMACY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SP
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANOPOLSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-851-7711
Mailing Address - Street 1:4024 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5708
Mailing Address - Country:US
Mailing Address - Phone:718-851-7711
Mailing Address - Fax:718-851-7747
Practice Address - Street 1:4024 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5708
Practice Address - Country:US
Practice Address - Phone:718-851-7711
Practice Address - Fax:718-851-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NY0306553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130566OtherPK
NY6575690001Medicare NSC