1336871607 NPI number — DREXEL DISTRIBUTION INC

Table of content: (NPI 1336871607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336871607 NPI number — DREXEL DISTRIBUTION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DREXEL DISTRIBUTION 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:
Provider Other Organization Name Type Code:
6
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:
1336871607
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3282
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10163-3282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-518-6900
Provider Business Mailing Address Fax Number:
866-252-3902

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PENN PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10119-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-518-6900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZORMATI
Authorized Official First Name:
BEDIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
917-653-8900

Provider Taxonomy Codes

  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 33D2254621 . This is a "NY STATE DEPT OF HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".