Provider Demographics
NPI:1942847371
Name:L.D.C. PHARMACY CORP
Entity Type:Organization
Organization Name:L.D.C. PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA-DITTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-369-5555
Mailing Address - Street 1:1825 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3829
Mailing Address - Country:US
Mailing Address - Phone:212-369-5555
Mailing Address - Fax:212-534-4517
Practice Address - Street 1:1825 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3829
Practice Address - Country:US
Practice Address - Phone:212-369-5555
Practice Address - Fax:212-534-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy