Provider Demographics
NPI:1982978011
Name:AMERICAN OUTCOMES MANAGEMENT OF NEW YORK LP
Entity Type:Organization
Organization Name:AMERICAN OUTCOMES MANAGEMENT OF NEW YORK LP
Other - Org Name:AMERICAN OUTCOMES MANAGEMENT, L.P.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-556-4246
Mailing Address - Street 1:1395 NW 17TH AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2551
Mailing Address - Country:US
Mailing Address - Phone:561-860-8300
Mailing Address - Fax:561-860-8319
Practice Address - Street 1:1395 NW 17TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2552
Practice Address - Country:US
Practice Address - Phone:561-860-8300
Practice Address - Fax:561-860-8319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 3336S0011X
FLPH259753336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5709502OtherNCPDP PROVIDER IDENTIFICATION NUMBER