Healthcare Provider Details

I. General information

NPI: 1770856395
Provider Name (Legal Business Name): SEVENTH ELM DRUG CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 03/02/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 7TH AVE
NEW YORK NY
10011-6672
US

IV. Provider business mailing address

56 7TH AVE
NEW YORK NY
10011-6672
US

V. Phone/Fax

Practice location:
  • Phone: 212-256-6100
  • Fax: 212-256-2112
Mailing address:
  • Phone: 212-256-6100
  • Fax: 212-256-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number030275
License Number StateNY

VIII. Authorized Official

Name: ELENA BARANOV
Title or Position: PRESIDENT
Credential:
Phone: 212-255-6100