Provider Demographics
NPI:1568741460
Name:MOMS PHARMACY OF NYC, INC.
Entity Type:Organization
Organization Name:MOMS PHARMACY OF NYC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHABEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-870-5129
Mailing Address - Street 1:224 W 29TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5204
Mailing Address - Country:US
Mailing Address - Phone:646-218-1710
Mailing Address - Fax:212-564-9271
Practice Address - Street 1:224 W 29TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5204
Practice Address - Country:US
Practice Address - Phone:646-218-1710
Practice Address - Fax:212-564-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy