Provider Demographics
NPI:1689851149
Name:DNT DRUGS LLC
Entity Type:Organization
Organization Name:DNT DRUGS LLC
Other - Org Name:VILLAGE PHARMACY AND SURGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPOVAC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-482-1160
Mailing Address - Street 1:124 E MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3532
Mailing Address - Country:US
Mailing Address - Phone:631-482-1160
Mailing Address - Fax:631-482-1159
Practice Address - Street 1:124 E MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3532
Practice Address - Country:US
Practice Address - Phone:631-482-1160
Practice Address - Fax:631-482-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0288023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3357375OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY02970107Medicaid
3357375OtherNCPDP PROVIDER IDENTIFICATION NUMBER