Provider Demographics
NPI:1407943608
Name:TRUCARE PHARMACY OF ROCKLAND INC
Entity Type:Organization
Organization Name:TRUCARE PHARMACY OF ROCKLAND INC
Other - Org Name:TRUCARE PHARMACY OF ROCKLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ SP
Authorized Official - Prefix:
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-364-5300
Mailing Address - Street 1:358 ROUTE 202
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3107
Mailing Address - Country:US
Mailing Address - Phone:845-364-5300
Mailing Address - Fax:845-364-9863
Practice Address - Street 1:358 ROUTE 202
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3107
Practice Address - Country:US
Practice Address - Phone:845-364-5300
Practice Address - Fax:845-364-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
NY0253913336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2064236OtherPK
NY02290724Medicaid
4788340001Medicare NSC