Provider Demographics
NPI:1417947300
Name:CITY DRUGS INC
Entity Type:Organization
Organization Name:CITY DRUGS INC
Other - Org Name:CITY DRUGS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINDER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-686-2727
Mailing Address - Street 1:422 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3108
Mailing Address - Country:US
Mailing Address - Phone:718-686-2727
Mailing Address - Fax:718-532-0855
Practice Address - Street 1:422 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3108
Practice Address - Country:US
Practice Address - Phone:718-686-2727
Practice Address - Fax:718-532-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025116333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02183053Medicaid
NY4228740001Medicare NSC