Provider Demographics
NPI:1689080939
Name:PRESCRIPTION PLUS AT SILVER LAKE LLC
Entity Type:Organization
Organization Name:PRESCRIPTION PLUS AT SILVER LAKE LLC
Other - Org Name:PRESCRIPTION PLUS AT SILVER LAKE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-949-3800
Mailing Address - Street 1:23 TAYLOR SQ
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-1908
Mailing Address - Country:US
Mailing Address - Phone:914-949-3800
Mailing Address - Fax:914-949-3840
Practice Address - Street 1:23 TAYLOR SQ
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-1908
Practice Address - Country:US
Practice Address - Phone:914-949-3800
Practice Address - Fax:914-949-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0327053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYY92488NEMedicaid