Provider Demographics
NPI:1205801560
Name:DRUG WORLD OF HILLCREST, LLC
Entity type:Organization
Organization Name:DRUG WORLD OF HILLCREST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-639-4952
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956
Mailing Address - Country:US
Mailing Address - Phone:845-639-4952
Mailing Address - Fax:845-639-4955
Practice Address - Street 1:275 NORTH MAIN STREET
Practice Address - Street 2:UNIT 12
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:845-352-1800
Practice Address - Fax:845-352-8645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024874332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02095889Medicaid
NY02095889Medicaid
NY4538600001Medicare NSC