Provider Demographics
NPI:1619026812
Name:ROCHDALE PHARMACY INC
Entity Type:Organization
Organization Name:ROCHDALE PHARMACY INC
Other - Org Name:APTEKA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MILAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:AWON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-389-4544
Mailing Address - Street 1:937 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-1624
Mailing Address - Country:US
Mailing Address - Phone:718-389-4544
Mailing Address - Fax:718-389-3313
Practice Address - Street 1:937 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-1624
Practice Address - Country:US
Practice Address - Phone:718-389-4544
Practice Address - Fax:718-389-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0223293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01526769Medicaid
NY022329OtherSTATE BOARD OF PHARMACY
NY01526769Medicaid