Provider Demographics
NPI:1386644987
Name:BRAUNAGEL & BRAUNAGEL, INC.
Entity Type:Organization
Organization Name:BRAUNAGEL & BRAUNAGEL, INC.
Other - Org Name:ALITON'S PHARMACY HOME HEALTHCARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:845-856-8314
Mailing Address - Street 1:12 SUSSEX ST
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-2421
Mailing Address - Country:US
Mailing Address - Phone:845-856-8314
Mailing Address - Fax:845-856-8315
Practice Address - Street 1:10-12 SUSSEX ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771
Practice Address - Country:US
Practice Address - Phone:845-856-8314
Practice Address - Fax:845-856-8315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336L0003X
NY0212573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014316110004Medicaid
NY01286268Medicaid
3322043OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ6464211Medicaid
3322043OtherNCPDP PROVIDER IDENTIFICATION NUMBER