Provider Demographics
NPI:1023501061
Name:ANCHOR HEALTH GROUP CORP
Entity type:Organization
Organization Name:ANCHOR HEALTH GROUP CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-879-7005
Mailing Address - Street 1:1926 CROTONA PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-1845
Mailing Address - Country:US
Mailing Address - Phone:347-879-7005
Mailing Address - Fax:347-879-7006
Practice Address - Street 1:1926 CROTONA PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-1845
Practice Address - Country:US
Practice Address - Phone:347-879-7005
Practice Address - Fax:347-879-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY036496OtherNYS STATE BOARD OF PHARMACY