Provider Demographics
NPI:1013006709
Name:ELMWOOD DRUGS INC
Entity Type:Organization
Organization Name:ELMWOOD DRUGS INC
Other - Org Name:ELMWOOD PARK PHARMACY/SURGICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:SILVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-796-0400
Mailing Address - Street 1:73 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-3007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:73 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3007
Practice Address - Country:US
Practice Address - Phone:201-796-0400
Practice Address - Fax:201-796-0695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00541200333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7195800Medicaid
NJ7195818Medicaid
NJ1157690001Medicaid
3117858OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ7195818Medicaid