Provider Demographics
NPI:1851372114
Name:SOUND SHORE PHARMACY, INC
Entity Type:Organization
Organization Name:SOUND SHORE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGALDI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-365-3975
Mailing Address - Street 1:12 N 7TH AVE
Mailing Address - Street 2:OUT-PATIENT PHARMACY
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2026
Mailing Address - Country:US
Mailing Address - Phone:914-371-1167
Mailing Address - Fax:914-664-0457
Practice Address - Street 1:12 N 7TH AVE
Practice Address - Street 2:OUT-PATIENT PHARMACY
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2026
Practice Address - Country:US
Practice Address - Phone:914-664-8000
Practice Address - Fax:914-664-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02673045Medicaid
NY027010OtherLICENSE
NYBS9127742OtherDEA NUMBER