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General NPI Number Information
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NPI Number | 1891150637
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Entity Type | Organization
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Legal Business Name | IPS INTEGRATED PHARMACY SPECIALS LLC
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 10 CORPORATE DR
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City | ORANGEBURG
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State | NY
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Zip | 10962-2614
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Country | US
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Telephone | 845-359-3300
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Fax | 845-359-3302
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Provider Business Mailing Address
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Address Line | 10 CORPORATE DR
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City | ORANGEBURG
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State | NY
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Zip | 10962-2614
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Country | US
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Telephone | 845-359-3300
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Fax | 845-359-3302
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Authorized Official
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Title or Position | OWNER/PHARMACIST-IN-CHARGE
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Name | MNESHA PATEL
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Credential |
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Telephone | 845-359-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 034012
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License Number State | NY
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