Provider Demographics
NPI:1629443825
Name:WOODSIDE CHEMISTS INC.
Entity Type:Organization
Organization Name:WOODSIDE CHEMISTS INC.
Other - Org Name:WOODSIDE CHEMISTS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-479-0838
Mailing Address - Street 1:5801 WOODSIDE AVE
Mailing Address - Street 2:STORE #3
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3437
Mailing Address - Country:US
Mailing Address - Phone:929-522-0324
Mailing Address - Fax:929-522-0567
Practice Address - Street 1:5801 WOODSIDE AVE
Practice Address - Street 2:STORE #3
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3437
Practice Address - Country:US
Practice Address - Phone:929-522-0324
Practice Address - Fax:929-522-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
NY0342373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2155968OtherPK
2155968OtherPK