Provider Demographics
NPI:1568447225
Name:AMATO PHARMACY, INC.
Entity Type:Organization
Organization Name:AMATO PHARMACY, INC.
Other - Org Name:AMATO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMENTILLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-365-8630
Mailing Address - Street 1:619 E 187TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-6706
Mailing Address - Country:US
Mailing Address - Phone:718-365-8630
Mailing Address - Fax:718-365-0267
Practice Address - Street 1:619 E 187TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6706
Practice Address - Country:US
Practice Address - Phone:718-365-8630
Practice Address - Fax:718-365-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00260100Medicaid
NY0904310001Medicare NSC