Provider Demographics
NPI:1568840304
Name:STATION PHARMACY, INC
Entity Type:Organization
Organization Name:STATION PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-220-4128
Mailing Address - Street 1:77-04 ROOSEVELT AVENUE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6610
Mailing Address - Country:US
Mailing Address - Phone:718-429-1730
Mailing Address - Fax:
Practice Address - Street 1:77-04 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6610
Practice Address - Country:US
Practice Address - Phone:718-429-1730
Practice Address - Fax:718-429-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy