Provider Demographics
NPI:1326328501
Name:LENOX STAR PHARMACY INC.
Entity Type:Organization
Organization Name:LENOX STAR PHARMACY INC.
Other - Org Name:HARLEM PHARMACY & SURGICALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DASARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-368-7900
Mailing Address - Street 1:531 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1809
Mailing Address - Country:US
Mailing Address - Phone:212-368-7900
Mailing Address - Fax:212-368-3999
Practice Address - Street 1:531 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1809
Practice Address - Country:US
Practice Address - Phone:212-368-7900
Practice Address - Fax:212-368-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03368476Medicaid
5803196OtherNCPDP
NY03368476Medicaid