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General NPI Number Information
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NPI Number | 1255507695
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Entity Type | Organization
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Legal Business Name | PRESTIGE PHARMACY INC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 36 42 JAMES ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 845-344-4433
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Fax | 845-344-4439
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Provider Business Mailing Address
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Address Line | 78 LAUREL HILL DR
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City | WESTTOWN
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State | NY
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Zip | 10998-3922
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Country | US
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Telephone | 845-344-4433
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Fax | 843-344-4439
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Authorized Official
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Title or Position | OWNER
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Name | AJAY PATEL
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Credential |
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Telephone | 845-344-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 028863
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License Number State | NY
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