Provider Demographics
NPI:1922028786
Name:UMA PHARMACY CORP
Entity Type:Organization
Organization Name:UMA PHARMACY CORP
Other - Org Name:ANSONIA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:UPENDRA
Authorized Official - Middle Name:DAYARAM
Authorized Official - Last Name:SOLANKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-677-6710
Mailing Address - Street 1:446 AVENUE OF THE AMERICAS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8424
Mailing Address - Country:US
Mailing Address - Phone:212-677-6710
Mailing Address - Fax:212-979-1578
Practice Address - Street 1:446 AVENUE OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8424
Practice Address - Country:US
Practice Address - Phone:212-477-0762
Practice Address - Fax:212-979-1578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0225263336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01565571Medicaid