Provider Demographics
NPI:1609980416
Name:PHARMACY OPERATIONS OF NEW YORK INC
Entity Type:Organization
Organization Name:PHARMACY OPERATIONS OF NEW YORK INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THIRD PARTY PLAN COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-993-6000
Mailing Address - Street 1:1806 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2234
Mailing Address - Country:US
Mailing Address - Phone:716-282-1112
Mailing Address - Fax:716-282-0654
Practice Address - Street 1:1806 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2234
Practice Address - Country:US
Practice Address - Phone:716-282-1112
Practice Address - Fax:716-282-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0284403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02888306Medicaid
NY3384485OtherNCPDP
NY00030005702OtherUNIVERA
NYFP0285761OtherDEA #
NYFP0285761OtherDEA #