Provider Demographics
NPI:1356419188
Name:ROCKY HILL PHARMACY INC
Entity type:Organization
Organization Name:ROCKY HILL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANDAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-343-8995
Mailing Address - Street 1:23601 BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1143
Mailing Address - Country:US
Mailing Address - Phone:718-343-8995
Mailing Address - Fax:718-343-1994
Practice Address - Street 1:23601 BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1143
Practice Address - Country:US
Practice Address - Phone:718-343-8995
Practice Address - Fax:718-343-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470997Medicaid
NY3331321OtherNABP NUMBER
NY0319970001Medicare NSC