Provider Demographics
NPI:1821317280
Name:AMS PHARMACY INC
Entity Type:Organization
Organization Name:AMS PHARMACY INC
Other - Org Name:TWIN PARKS PHARMACY AND SURGICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-433-2887
Mailing Address - Street 1:817 E 180TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-1305
Mailing Address - Country:US
Mailing Address - Phone:718-618-7436
Mailing Address - Fax:718-513-4244
Practice Address - Street 1:817 E 180TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-1305
Practice Address - Country:US
Practice Address - Phone:718-618-7436
Practice Address - Fax:718-513-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0302153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5800998OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY03297252Medicaid
NY6461960001Medicare NSC