Provider Demographics
NPI:1962506923
Name:C AND D DRUG CORP
Entity Type:Organization
Organization Name:C AND D DRUG CORP
Other - Org Name:WORLDS FAIR LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CATALANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-358-1300
Mailing Address - Street 1:57 37 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-358-1300
Mailing Address - Fax:718-762-7140
Practice Address - Street 1:57 37 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-358-1300
Practice Address - Fax:718-762-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336M0003X, 3336S0011X
NY159413336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3309855OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY00263254Medicaid
3309855OtherNCPDP PROVIDER IDENTIFICATION NUMBER