Provider Demographics
NPI:1447416284
Name:HOMECARE CONCEPTS PHARMACY
Entity Type:Organization
Organization Name:HOMECARE CONCEPTS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-752-0555
Mailing Address - Street 1:1095 ROUTE 110
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4815
Mailing Address - Country:US
Mailing Address - Phone:631-752-0555
Mailing Address - Fax:631-752-8041
Practice Address - Street 1:226 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2618
Practice Address - Country:US
Practice Address - Phone:631-752-0555
Practice Address - Fax:631-752-8040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE CONCEPTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025345333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy