1487798484 NPI number — SCHNEIDER'S PHARMACY,INC.

Table of content: (NPI 1487798484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487798484 NPI number — SCHNEIDER'S PHARMACY,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHNEIDER'S PHARMACY,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:
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:
1487798484
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:
FIVE MILE POINT PLAZA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KIRKWOOD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13795
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-775-0245
Provider Business Mailing Address Fax Number:
607-775-0272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FIVE MILE POINT PLAZA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KIRKWOOD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-775-0245
Provider Business Practice Location Address Fax Number:
607-775-0272
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHNEIDER
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
607-775-0245

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  021305 , 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: 01303635 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3323021 . This is a "NABP NUMBER" identifier . This identifiers is of the category "OTHER".




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