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NPI Code Detail

MEDICARE: PELHAM PHARMACY INC

MEDICARE: PELHAM PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy032726NY
23336L0003XLong Term Care Pharmacy032726NY
33336S0011XSpecialty Pharmacy032726NY
4333600000XPharmacy032726NY

General Provider Information

NPI Number : 1518387331
Entity Type Code : Organization
Provider Name (Legal Business Name) : PELHAM PHARMACY INC
Provider Business Mailing Address
First Line : 2171 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10462-1405
Country : US
Telephone Number : 917-708-9700
Fax Number : 917-708-9702
Provider Business Practice Location Address
First Line : 2171 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10462-1405
Country : US
Telephone Number : 917-708-9700
Fax Number : 917-708-9702
Authorized Official
Title or Position : VICE PRESIDENT
Name : HOUSSAM NASSER
Credential : PHARMD
Telephone Number : 347-419-6737
Provider Enumeration Date : 04/19/2014
Last Update Date : 11/29/2014

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Directions to “PELHAM PHARMACY INC ” Practice Location

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