Provider Demographics
NPI:1578618740
Name:CATSKILL PHARMACY INC
Entity Type:Organization
Organization Name:CATSKILL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ATIQUR
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:845-626-0900
Mailing Address - Street 1:6401 RT 209 USHIGHWAY
Mailing Address - Street 2:
Mailing Address - City:KERHONKSON
Mailing Address - State:NY
Mailing Address - Zip Code:12446
Mailing Address - Country:US
Mailing Address - Phone:845-626-0900
Mailing Address - Fax:845-626-5546
Practice Address - Street 1:6401 RT 209 US HIGHWAY
Practice Address - Street 2:
Practice Address - City:KERHONKSON
Practice Address - State:NY
Practice Address - Zip Code:12446
Practice Address - Country:US
Practice Address - Phone:845-626-0900
Practice Address - Fax:845-626-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0248633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02092955Medicaid
NY02092955Medicaid