Provider Demographics
NPI:1952316572
Name:SHIPMANS PHARMACY INC
Entity Type:Organization
Organization Name:SHIPMANS PHARMACY INC
Other - Org Name:HENRY CUNNINGHAM
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-483-1767
Mailing Address - Street 1:210 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5613
Mailing Address - Country:US
Mailing Address - Phone:516-483-1767
Mailing Address - Fax:516-481-4905
Practice Address - Street 1:210 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5613
Practice Address - Country:US
Practice Address - Phone:516-483-1767
Practice Address - Fax:516-481-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3394462OtherOTHER ID NUMBER
3394462OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NY07487396Medicaid