Provider Demographics
NPI:1609881291
Name:SOMMA PHARMACEUTICAL CO LTD
Entity Type:Organization
Organization Name:SOMMA PHARMACEUTICAL CO LTD
Other - Org Name:ARTIS DRUG CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-429-6611
Mailing Address - Street 1:80 02 ELIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379
Mailing Address - Country:US
Mailing Address - Phone:718-429-6611
Mailing Address - Fax:718-672-6759
Practice Address - Street 1:80 02 ELIOT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379
Practice Address - Country:US
Practice Address - Phone:718-429-6611
Practice Address - Fax:718-672-6759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NY0163803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057345OtherPK
NY00350303Medicaid
0406130001Medicare NSC