Provider Demographics
NPI:1326794173
Name:ST. BARNABAS HOSPITAL
Entity Type:Organization
Organization Name:ST. BARNABAS HOSPITAL
Other - Org Name:ST. BARNABAS HOSPITAL SPECIALTY PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:SVP CHEIF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMD MBA FACH
Authorized Official - Phone:718-960-6180
Mailing Address - Street 1:4487 3RD AVE
Mailing Address - Street 2:SPECIALTY PHARMACY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-1526
Mailing Address - Country:US
Mailing Address - Phone:718-960-9221
Mailing Address - Fax:718-960-5564
Practice Address - Street 1:4487 3RD AVE
Practice Address - Street 2:SPECIALTY PHARMACY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1526
Practice Address - Country:US
Practice Address - Phone:718-960-9221
Practice Address - Fax:718-960-5564
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. BARNABAS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-01
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy