Provider Demographics
NPI:1023529245
Name:ALPINA PHARMACY INC.
Entity type:Organization
Organization Name:ALPINA PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABO
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-261-5204
Mailing Address - Street 1:155 W 145TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-4210
Mailing Address - Country:US
Mailing Address - Phone:917-261-5204
Mailing Address - Fax:917-261-5302
Practice Address - Street 1:155 W 145TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-4210
Practice Address - Country:US
Practice Address - Phone:917-261-5204
Practice Address - Fax:917-261-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-15
Last Update Date:2017-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy