Healthcare Provider Details

I. General information

NPI: 1306215983
Provider Name (Legal Business Name): NEW YORK CITY HEALTH & HOSPITALS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2015
Last Update Date: 03/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WHITE ST 2ND FLOOR PHARMACY
NEW YORK NY
10013-4497
US

IV. Provider business mailing address

125 WHITE ST 2ND FLOOR PHARMACY
NEW YORK NY
10013-4497
US

V. Phone/Fax

Practice location:
  • Phone: 347-774-7241
  • Fax: 347-774-8140
Mailing address:
  • Phone: 347-774-7241
  • Fax: 347-774-8140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number017918
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS HAYDEN
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 347-774-7004