Provider Demographics
NPI:1598770463
Name:COMMUNITY PHARMACY SERVICES INC.
Entity Type:Organization
Organization Name:COMMUNITY PHARMACY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RADMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-739-6500
Mailing Address - Street 1:1190 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2633
Mailing Address - Country:US
Mailing Address - Phone:631-368-6423
Mailing Address - Fax:
Practice Address - Street 1:15211 89TH AVE
Practice Address - Street 2:ATT: JOE RADMAN
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3730
Practice Address - Country:US
Practice Address - Phone:631-739-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3383863OtherNCPDP
NY01009750Medicaid
NY01009750Medicaid