Provider Demographics
NPI:1639422447
Name:CHELSEA PHARMACY INC
Entity Type:Organization
Organization Name:CHELSEA PHARMACY INC
Other - Org Name:CHELSEA PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-255-9900
Mailing Address - Street 1:171 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-255-9900
Mailing Address - Fax:212-255-7916
Practice Address - Street 1:171 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-255-9900
Practice Address - Fax:212-255-7916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0314883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139488OtherPK