Provider Demographics
NPI:1346259660
Name:VALUE DRUGS EAST, INC.
Entity Type:Organization
Organization Name:VALUE DRUGS EAST, INC.
Other - Org Name:VALUE DRUGS EAST INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING RPH
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEFORTE
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:914-771-5640
Mailing Address - Street 1:1 TUCKAHOE AVE
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2924
Mailing Address - Country:US
Mailing Address - Phone:914-771-5640
Mailing Address - Fax:914-771-8494
Practice Address - Street 1:1 TUCKAHOE AVE
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2924
Practice Address - Country:US
Practice Address - Phone:914-771-5640
Practice Address - Fax:914-771-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0277953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2068100OtherPK
NY02924050Medicaid
NY02924050Medicaid