Provider Demographics
NPI:1710288915
Name:ARYA PHARMACY CORP
Entity Type:Organization
Organization Name:ARYA PHARMACY CORP
Other - Org Name:HEALTH CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUMMAKONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-585-1117
Mailing Address - Street 1:567 COURTLANDT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5015
Mailing Address - Country:US
Mailing Address - Phone:718-585-1117
Mailing Address - Fax:347-431-4015
Practice Address - Street 1:567 COURTLANDT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5015
Practice Address - Country:US
Practice Address - Phone:718-585-1117
Practice Address - Fax:347-431-4015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0306213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5802473OtherNCPDP PROVIDER IDENTIFICATION NUMBER