Provider Demographics
NPI:1962489062
Name:NAMDOR INC
Entity Type:Organization
Organization Name:NAMDOR INC
Other - Org Name:GRISTEDES PHARMACY #545
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-217-2789
Mailing Address - Street 1:227 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4934
Mailing Address - Country:US
Mailing Address - Phone:212-807-0950
Mailing Address - Fax:212-243-1568
Practice Address - Street 1:227 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4934
Practice Address - Country:US
Practice Address - Phone:212-807-0950
Practice Address - Fax:212-243-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02092006Medicaid
3316886OtherNCPDP
3316886OtherNCPDP
NY02092006Medicaid