MEDICARE: SOUND SHORE 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
1	183500000X	Pharmacist	027010	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	027010	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1851372114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUND SHORE PHARMACY, INC

Provider Business Mailing Address
First Line	:	12 N 7TH AVE
Second Line	:	OUT-PATIENT PHARMACY
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-2026
Country	:	US
Telephone Number	:	914-371-1167
Fax Number	:	914-664-0457

Provider Business Practice Location Address
First Line	:	12 N 7TH AVE
Second Line	:	OUT-PATIENT PHARMACY
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-2026
Country	:	US
Telephone Number	:	914-664-8000
Fax Number	:	914-664-0457

Authorized Official
Title or Position	:	PHARMACY ADMINISTRATOR
Name	:	MRS. THOMAS MAGALDI
Credential	:	RPH
Telephone Number	:	914-365-3975

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	03/07/2023

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Directions to “SOUND SHORE PHARMACY, INC ” Practice Location

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