Provider Demographics
NPI:1306044557
Name:VENUS PHARMACY AND SUPPLIES CORP
Entity Type:Organization
Organization Name:VENUS PHARMACY AND SUPPLIES CORP
Other - Org Name:VENUS PHARMACY AND SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-666-4800
Mailing Address - Street 1:972 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3002
Mailing Address - Country:US
Mailing Address - Phone:212-666-4800
Mailing Address - Fax:212-666-1145
Practice Address - Street 1:972 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3002
Practice Address - Country:US
Practice Address - Phone:212-666-4800
Practice Address - Fax:212-666-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0284543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3356967OtherNCPDP PROVIDER IDENTIFICATION NUMBER
5990220001Medicare NSC