Provider Demographics
NPI:1013231380
Name:GARDEN CITY CHEMISTS INC
Entity Type:Organization
Organization Name:GARDEN CITY CHEMISTS INC
Other - Org Name:GARDEN CITY CHEMISTS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMBACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-273-0008
Mailing Address - Street 1:PO BOX 753
Mailing Address - Street 2:
Mailing Address - City:POINT LOOKOUT
Mailing Address - State:NY
Mailing Address - Zip Code:11569-0753
Mailing Address - Country:US
Mailing Address - Phone:917-273-0008
Mailing Address - Fax:
Practice Address - Street 1:152 7TH ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5725
Practice Address - Country:US
Practice Address - Phone:917-273-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030169333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3364875OtherNCPDP PROVIDER IDENTIFICATION NUMBER