Provider Demographics
NPI:1710033162
Name:PREFERRED PHARMACY INC
Entity Type:Organization
Organization Name:PREFERRED PHARMACY INC
Other - Org Name:PREFERRED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUP. PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-483-5000
Mailing Address - Street 1:175 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3718
Mailing Address - Country:US
Mailing Address - Phone:516-483-5000
Mailing Address - Fax:516-483-5047
Practice Address - Street 1:175 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3718
Practice Address - Country:US
Practice Address - Phone:516-483-5000
Practice Address - Fax:516-483-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0281723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2858015Medicaid
2068928OtherPK