Provider Demographics
NPI:1720397920
Name:NORWOOD PHARMACY LLC
Entity Type:Organization
Organization Name:NORWOOD PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:PIPALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-234-6611
Mailing Address - Street 1:2490 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2792
Mailing Address - Country:US
Mailing Address - Phone:212-234-6611
Mailing Address - Fax:212-234-6992
Practice Address - Street 1:2490 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2792
Practice Address - Country:US
Practice Address - Phone:212-234-6611
Practice Address - Fax:212-234-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030308333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6483060001Medicare NSC