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General NPI Number Information
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NPI Number | 1205284817
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Entity Type | Organization
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Legal Business Name | RIDGE CHEMISTS, LLC
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 122 BAY RIDGE AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-5052
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Country | US
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Telephone | 718-333-5979
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Fax | 718-333-5983
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Provider Business Mailing Address
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Address Line | 122 BAY RIDGE AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-5052
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Country | US
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Telephone | 718-333-5979
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Fax | 718-333-5983
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Authorized Official
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Title or Position | OWNER
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Name | MARIANO PINEDA
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Credential |
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Telephone | 917-407-7993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 034650
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 034650
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License Number State | NY
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