Healthcare Provider Details

I. General information

NPI: 1285727016
Provider Name (Legal Business Name): STEVEN A PARDI R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTRAL AVE SCRIPTS PLUS,INC DBA THE MEDICINE SHOPPE#1579
ILION NY
13357-1822
US

IV. Provider business mailing address

10 CENTRAL AVE SCRIPTS PLUS INC., DBA THE MEDICINE SHOPPE #1579
ILION NY
13357-1822
US

V. Phone/Fax

Practice location:
  • Phone: 315-894-7283
  • Fax: 315-894-8879
Mailing address:
  • Phone: 315-894-7283
  • Fax: 315-895-0613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033490
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: