Healthcare Provider Details

I. General information

NPI: 1356377089
Provider Name (Legal Business Name): ST BARNABAS HOSPITAL-PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 3RD AVE
BRONX NY
10457-2545
US

IV. Provider business mailing address

4422 3RD AVE
BRONX NY
10457-2545
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-3989
  • Fax: 718-960-3996
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number000564
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD LA FONTAINE
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 718-960-6180