Provider Demographics
NPI:1699176396
Name:WESTCHESTER COMPOUNDING PHARMACY, INC.
Entity Type:Organization
Organization Name:WESTCHESTER COMPOUNDING PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIKOUNAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:914-200-1222
Mailing Address - Street 1:274 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-4419
Mailing Address - Country:US
Mailing Address - Phone:914-200-1222
Mailing Address - Fax:914-337-2524
Practice Address - Street 1:274 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-4419
Practice Address - Country:US
Practice Address - Phone:914-200-1222
Practice Address - Fax:914-337-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032859333600000X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy