Provider Demographics
NPI:1952495368
Name:CALVO DRUG INC
Entity Type:Organization
Organization Name:CALVO DRUG INC
Other - Org Name:EAST HAMPTON PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARM
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-324-3887
Mailing Address - Street 1:106 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-2640
Mailing Address - Country:US
Mailing Address - Phone:631-324-3887
Mailing Address - Fax:631-324-3985
Practice Address - Street 1:106 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-2640
Practice Address - Country:US
Practice Address - Phone:631-324-3887
Practice Address - Fax:631-324-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
NY0263923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02520616Medicaid
3336648OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3336648OtherNCPDP PROVIDER IDENTIFICATION NUMBER