Provider Demographics
NPI:1245571116
Name:SLATE HILL CHEMISTS INC
Entity Type:Organization
Organization Name:SLATE HILL CHEMISTS INC
Other - Org Name:SLATE HILL NEIGHBORX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / SP
Authorized Official - Prefix:
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:SQUITIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-355-5555
Mailing Address - Street 1:2904 ROUTE 6
Mailing Address - Street 2:STE 8-9
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-3810
Mailing Address - Country:US
Mailing Address - Phone:845-355-5555
Mailing Address - Fax:845-355-2525
Practice Address - Street 1:2904 ROUTE 6 STE 8-9
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-3810
Practice Address - Country:US
Practice Address - Phone:845-355-5555
Practice Address - Fax:845-355-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0320723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139256OtherPK
NY03940076Medicaid
NY03940076Medicaid