=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215911953
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST 14 PHARMACY CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2005
-----------------------------------------------------
Last Update Date | 08/06/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 312 W 14TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10014-5002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-727-7979
-----------------------------------------------------
Fax | 212-645-5693
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 312 W 14TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10014-5002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-727-7979
-----------------------------------------------------
Fax | 212-645-5693
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. PARESHBHAI DESAI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-727-7979
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 024776
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------