Provider Demographics
NPI:1306215983
Name:NEW YORK CITY HEALTH & HOSPITALS CORPORATION
Entity Type:Organization
Organization Name:NEW YORK CITY HEALTH & HOSPITALS CORPORATION
Other - Org Name:MANHATTAN DETENTION COMP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-774-7004
Mailing Address - Street 1:125 WHITE ST
Mailing Address - Street 2:2ND FLOOR PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4497
Mailing Address - Country:US
Mailing Address - Phone:347-774-7241
Mailing Address - Fax:347-774-8140
Practice Address - Street 1:125 WHITE ST
Practice Address - Street 2:2ND FLOOR PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4497
Practice Address - Country:US
Practice Address - Phone:347-774-7241
Practice Address - Fax:347-774-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017918333600000X
3336C0003X, 3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158339OtherPK