Provider Demographics
NPI:1417578899
Name:ALTO PHARMACY, LLC
Entity Type:Organization
Organization Name:ALTO PHARMACY, LLC
Other - Org Name:ALTO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. MANAGER OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-874-5881
Mailing Address - Street 1:645 HARRISON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3624
Mailing Address - Country:US
Mailing Address - Phone:800-841-5881
Mailing Address - Fax:415-484-7058
Practice Address - Street 1:100 PARK AVE STE FRONTE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5516
Practice Address - Country:US
Practice Address - Phone:800-874-5881
Practice Address - Fax:415-484-7058
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTO PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-27
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038332OtherPHARMACY
NY5831866OtherNCPDP
NYFS9716056OtherDEA