1346678778 NPI number — ARCADIA HEALTH PHARMACY CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346678778 NPI number — ARCADIA HEALTH PHARMACY CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCADIA HEALTH PHARMACY CORP
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:
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:
1346678778
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 520922
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11352-0922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-878-6999
Provider Business Mailing Address Fax Number:
718-939-8838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42-35 MAIN STREET UNIT 1L
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-878-6999
Provider Business Practice Location Address Fax Number:
718-939-8838
Provider Enumeration Date:
10/22/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HE
Authorized Official First Name:
JIA
Authorized Official Middle Name:
YING
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
718-878-6999

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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