Provider Demographics
NPI:1528389202
Name:COMMUNITY CARE PHARMACY INC
Entity Type:Organization
Organization Name:COMMUNITY CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAHID
Authorized Official - Middle Name:UZ
Authorized Official - Last Name:ZAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-267-5945
Mailing Address - Street 1:15 S ROUTE 303
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2449
Mailing Address - Country:US
Mailing Address - Phone:845-267-5945
Mailing Address - Fax:
Practice Address - Street 1:15 S ROUTE 303
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-2449
Practice Address - Country:US
Practice Address - Phone:845-267-5945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030091333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6453130001Medicare NSC