Provider Demographics
NPI:1912451030
Name:EAST MAIN STREET CHEMISTS INC
Entity Type:Organization
Organization Name:EAST MAIN STREET CHEMISTS INC
Other - Org Name:NEIGHBORX PHARMACY AT ORMC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-343-6666
Mailing Address - Street 1:707 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2650
Mailing Address - Country:US
Mailing Address - Phone:845-333-7250
Mailing Address - Fax:845-333-7249
Practice Address - Street 1:707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2650
Practice Address - Country:US
Practice Address - Phone:845-333-7250
Practice Address - Fax:845-333-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0350203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100162959OtherMEDICARE - NSC - MASS IMMUNIZATION
2162457OtherPK
NY035020OtherBOARD OF PHARMACY
NY5818274OtherNCPDP
NY5818274OtherNCPDP
NYFE6455580OtherDEA