Provider Demographics
NPI:1760640296
Name:BLACK DRUGS INC
Entity Type:Organization
Organization Name:BLACK DRUGS INC
Other - Org Name:GARRO DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-732-6915
Mailing Address - Street 1:704 BLEECKER ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1406
Mailing Address - Country:US
Mailing Address - Phone:315-732-6915
Mailing Address - Fax:315-732-6641
Practice Address - Street 1:704 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1406
Practice Address - Country:US
Practice Address - Phone:315-732-6915
Practice Address - Fax:315-732-6641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-31
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0288493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy