Provider Demographics
NPI:1841737913
Name:EMPIRE SPECIALTY PHARMACY
Entity Type:Organization
Organization Name:EMPIRE SPECIALTY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-236-2170
Mailing Address - Street 1:6509 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1608
Mailing Address - Country:US
Mailing Address - Phone:877-236-2170
Mailing Address - Fax:
Practice Address - Street 1:6509 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1608
Practice Address - Country:US
Practice Address - Phone:877-236-2170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007160003336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy