Provider Demographics
NPI:1205324753
Name:NARAYAN PHARMACY 3 LLC
Entity type:Organization
Organization Name:NARAYAN PHARMACY 3 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PURVESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:914-874-6567
Mailing Address - Street 1:175 MEMORIAL HWY STE 1-14
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5639
Mailing Address - Country:US
Mailing Address - Phone:914-365-7099
Mailing Address - Fax:914-365-7066
Practice Address - Street 1:175 MEMORIAL HWY
Practice Address - Street 2:STE 1-14
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5639
Practice Address - Country:US
Practice Address - Phone:914-365-7099
Practice Address - Fax:914-365-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0361043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
7745520001OtherPTAN
NY05581282Medicaid