Provider Demographics
NPI:1760149975
Name:31ST & 3RD PHARMACY INC
Entity Type:Organization
Organization Name:31ST & 3RD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGULATORY COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-236-1538
Mailing Address - Street 1:10604 COURSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4015
Mailing Address - Country:US
Mailing Address - Phone:225-236-1550
Mailing Address - Fax:
Practice Address - Street 1:307 W 38TH ST STE 5-013
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-2913
Practice Address - Country:US
Practice Address - Phone:212-380-1840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:31ST & 3RD PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy