Provider Demographics
NPI:1508802455
Name:HUDSON PHARMACY & SURGICAL SUPPLIES INC
Entity Type:Organization
Organization Name:HUDSON PHARMACY & SURGICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICAL EQUIPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:FRUSTACE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:914-941-4476
Mailing Address - Street 1:40 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4716
Mailing Address - Country:US
Mailing Address - Phone:914-941-4476
Mailing Address - Fax:914-941-2122
Practice Address - Street 1:40 SPRING ST
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4716
Practice Address - Country:US
Practice Address - Phone:914-941-4476
Practice Address - Fax:914-941-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015349332BC3200X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3350915OtherNABP
NY00513671Medicaid
NY3350915OtherNABP