1144235771 NPI number — TAGLIA OPERATIONS INC

Table of content: (NPI 1144235771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144235771 NPI number — TAGLIA OPERATIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAGLIA OPERATIONS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TAGS PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144235771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 GUY PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMSTERDAM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12010-3225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 GUY PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMSTERDAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12010-3225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-843-5406
Provider Business Practice Location Address Fax Number:
518-843-6509
Provider Enumeration Date:
07/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAGLIAFERRI
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRES PHARMACIST
Authorized Official Telephone Number:
518-843-5406

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  025263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02247794 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3398939 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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