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General NPI Number Information
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NPI Number | 1093981557
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Entity Type | Organization
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Legal Business Name | ST MARYS HOSPITAL FOR CHILDREN INC.
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 2901 216TH ST ATTN: PHARMACY
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City | BAYSIDE
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State | NY
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Zip | 11360-2810
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Country | US
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Telephone | 718-281-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 216TH ST ATTN: PHARMACY
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City | BAYSIDE
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State | NY
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Zip | 11360-2810
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Country | US
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Telephone | 718-281-8866
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. EDDIE SIMPSER
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Credential | M.D.
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Telephone | 718-281-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State | NY
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