Provider Demographics
NPI:1508357989
Name:HCOR SPECIALTY PHARMACY LLC
Entity Type:Organization
Organization Name:HCOR SPECIALTY PHARMACY LLC
Other - Org Name:HCOR HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DMITRIY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PERELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:888-425-4267
Mailing Address - Street 1:11659 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6533
Mailing Address - Country:US
Mailing Address - Phone:888-425-4267
Mailing Address - Fax:347-565-0326
Practice Address - Street 1:11659 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6533
Practice Address - Country:US
Practice Address - Phone:888-425-4267
Practice Address - Fax:347-565-0326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
NY0365423336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177951OtherPK