Provider Demographics
NPI:1295778959
Name:NEW ROCHELLE PRESCRIPTION CENTER INC
Entity type:Organization
Organization Name:NEW ROCHELLE PRESCRIPTION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:POPATLAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:914-636-2225
Mailing Address - Street 1:551 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7214
Mailing Address - Country:US
Mailing Address - Phone:914-636-2225
Mailing Address - Fax:914-235-1120
Practice Address - Street 1:551 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7214
Practice Address - Country:US
Practice Address - Phone:914-636-2225
Practice Address - Fax:914-235-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0172033336C0003X, 333600000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00621994Medicaid
3336802OtherNABP OR NCPDP
NY00621994Medicaid