Provider Demographics
NPI:1346361722
Name:INTER ISLAND PHARMACY
Entity Type:Organization
Organization Name:INTER ISLAND PHARMACY
Other - Org Name:DOCTORS CHOICE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:JINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-775-0484
Mailing Address - Street 1:PO BOX 11536
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-4536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4C AND 4D ESTATE SION FARM
Practice Address - Street 2:
Practice Address - City:ST CROIX
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-778-2266
Practice Address - Fax:340-778-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VI2202843120073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5300152OtherOTHER ID NUMBER
5300152OtherOTHER ID NUMBER-COMMERCIAL NUMBER