Provider Demographics
NPI:1942297247
Name:RO PAUL DRUG CORP
Entity Type:Organization
Organization Name:RO PAUL DRUG CORP
Other - Org Name:TOWER PHARMACY AND SURGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES RPH CF
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RATTINER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-526-1121
Mailing Address - Street 1:185 12 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4860
Mailing Address - Country:US
Mailing Address - Phone:718-526-1121
Mailing Address - Fax:718-526-1272
Practice Address - Street 1:185 12 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4860
Practice Address - Country:US
Practice Address - Phone:718-526-1121
Practice Address - Fax:718-526-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-01
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0108263336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2060614OtherPK
NY00260673Medicaid
2060614OtherPK