Provider Demographics
NPI:1477071850
Name:ATRIUM CHEMIST INC
Entity Type:Organization
Organization Name:ATRIUM CHEMIST INC
Other - Org Name:ATRIUM RX PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/AO
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEUNG CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-784-7777
Mailing Address - Street 1:775 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3976
Mailing Address - Country:US
Mailing Address - Phone:631-784-7777
Mailing Address - Fax:631-980-7700
Practice Address - Street 1:775 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3976
Practice Address - Country:US
Practice Address - Phone:631-784-7777
Practice Address - Fax:631-980-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0357983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04866193Medicaid
2172184OtherPK