Provider Demographics
NPI:1285201608
Name:PEOPLE'S CHOICE PHARMACY NY CORP
Entity Type:Organization
Organization Name:PEOPLE'S CHOICE PHARMACY NY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-442-7150
Mailing Address - Street 1:423 JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2226
Mailing Address - Country:US
Mailing Address - Phone:718-442-7150
Mailing Address - Fax:
Practice Address - Street 1:423 JERSEY ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2226
Practice Address - Country:US
Practice Address - Phone:718-442-7150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy