Provider Demographics
NPI:1598770117
Name:CANAL PHARMACY INC
Entity Type:Organization
Organization Name:CANAL PHARMACY INC
Other - Org Name:CANAL PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-608-1668
Mailing Address - Street 1:196 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4562
Mailing Address - Country:US
Mailing Address - Phone:212-608-1668
Mailing Address - Fax:212-608-1008
Practice Address - Street 1:196 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4562
Practice Address - Country:US
Practice Address - Phone:212-608-1668
Practice Address - Fax:212-608-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NY0276303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02721066Medicaid
2067427OtherPK
NY02721066Medicaid