Provider Demographics
NPI:1770856395
Name:SEVENTH ELM DRUG CORP.
Entity Type:Organization
Organization Name:SEVENTH ELM DRUG CORP.
Other - Org Name:ELM CARE HEALTH ORGANIZATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-255-6100
Mailing Address - Street 1:56 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6672
Mailing Address - Country:US
Mailing Address - Phone:212-256-6100
Mailing Address - Fax:212-256-2112
Practice Address - Street 1:56 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6672
Practice Address - Country:US
Practice Address - Phone:212-256-6100
Practice Address - Fax:212-256-2112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEVENTH ELM DRUG CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-13
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
NY0302753336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03283387Medicaid
5804388OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY03283387Medicaid