Provider Demographics
NPI:1992832315
Name:SCHELLS PHARMACY INC
Entity Type:Organization
Organization Name:SCHELLS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:RAKSTIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH CF
Authorized Official - Phone:518-842-5460
Mailing Address - Street 1:179 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-4818
Mailing Address - Country:US
Mailing Address - Phone:518-842-5460
Mailing Address - Fax:518-842-1059
Practice Address - Street 1:179 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4818
Practice Address - Country:US
Practice Address - Phone:518-842-5460
Practice Address - Fax:518-842-1059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X
NY0267093336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02587575Medicaid
NY02587575Medicaid