Provider Demographics
NPI:1184454647
Name:STATION PHARMACY NY LLC
Entity type:Organization
Organization Name:STATION PHARMACY NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-418-8953
Mailing Address - Street 1:1757 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2407
Mailing Address - Country:US
Mailing Address - Phone:631-418-8953
Mailing Address - Fax:631-418-8954
Practice Address - Street 1:1757 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2407
Practice Address - Country:US
Practice Address - Phone:631-418-8953
Practice Address - Fax:631-418-8954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy