Provider Demographics
NPI:1932979036
Name:WILLOW PHARMACY CORP
Entity Type:Organization
Organization Name:WILLOW PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:646-265-2557
Mailing Address - Street 1:1002 BEACH 20TH ST UNIT 1R
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3900
Mailing Address - Country:US
Mailing Address - Phone:347-619-8880
Mailing Address - Fax:
Practice Address - Street 1:1002 BEACH 20TH ST UNIT 1R
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3900
Practice Address - Country:US
Practice Address - Phone:347-619-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy