Provider Demographics
NPI:1821184607
Name:TULIP DRUGS INC
Entity Type:Organization
Organization Name:TULIP DRUGS INC
Other - Org Name:LEES DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-354-2000
Mailing Address - Street 1:160 TULIP AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2706
Mailing Address - Country:US
Mailing Address - Phone:516-354-2000
Mailing Address - Fax:516-775-2046
Practice Address - Street 1:160 TULIP AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2706
Practice Address - Country:US
Practice Address - Phone:516-354-2000
Practice Address - Fax:516-775-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NY0099973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00380772Medicaid
3302851OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1245330001Medicare NSC