Provider Demographics
NPI:1912082447
Name:PHARAMCY CENTER INC
Entity Type:Organization
Organization Name:PHARAMCY CENTER INC
Other - Org Name:PHARMACY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILANO
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:914-747-5002
Mailing Address - Street 1:341 HALSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-3727
Mailing Address - Country:US
Mailing Address - Phone:914-835-4646
Mailing Address - Fax:914-835-0038
Practice Address - Street 1:341 HALSTEAD AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-3727
Practice Address - Country:US
Practice Address - Phone:914-835-4646
Practice Address - Fax:914-835-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0198473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02664753Medicaid
3392189OtherNCPDP PROVIDER IDENTIFICATION NUMBER