Port Ewen Pharmacy

LBN: Port Ewen Rx Inc
Port Ewen Pharmacy is an health care organization with primary practice located at 177 Broadway , Port Ewen NY 12466-7719. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Port Ewen Rx Inc can be contacted via phone (845) 331-4229, or through Adusumilli, Vinay via phone (440) 281-2324.

Contact Information

Primary practice address
177 Broadway Port Ewen NY 12466-7719
Phone: (845) 331-4229
Fax: (845) 340-4593
Website:
Map and Directions
Authorized official contact:
Name: Adusumilli, Vinay
Phone: (440) 281-2324

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 032682 New York
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1821426321
LBN Legal business name Port Ewen Rx Inc
DBA Doing business as Port Ewen Pharmacy
Authorized official Adusumilli, Vinay
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2013
Last updated Dec 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821426321 NPPES
Other 2147379 PK

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