Provider Demographics
NPI:1689101826
Name:ANGELO FRIELLO INC
Entity Type:Organization
Organization Name:ANGELO FRIELLO INC
Other - Org Name:PALMER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:914-747-5004
Mailing Address - Street 1:2 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-2623
Mailing Address - Country:US
Mailing Address - Phone:518-762-8319
Mailing Address - Fax:518-762-5272
Practice Address - Street 1:2 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-2623
Practice Address - Country:US
Practice Address - Phone:518-762-8319
Practice Address - Fax:518-762-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16393333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAF1109621OtherDEA