Provider Demographics
NPI:1619205663
Name:ARLINGTON PHARMACY INC.
Entity Type:Organization
Organization Name:ARLINGTON PHARMACY INC.
Other - Org Name:K&K PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:845-292-3430
Mailing Address - Street 1:187 MILL ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-2000
Mailing Address - Country:US
Mailing Address - Phone:845-747-4477
Mailing Address - Fax:845-747-4482
Practice Address - Street 1:187 MILL ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-2000
Practice Address - Country:US
Practice Address - Phone:845-747-4477
Practice Address - Fax:845-747-4482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0298133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03206782Medicaid
NY6399120001Medicare NSC