Provider Demographics
NPI:1902062987
Name:DELCO DRUGS & SPECIALTY PHARMACY INC.
Entity Type:Organization
Organization Name:DELCO DRUGS & SPECIALTY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANNICHARICO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-984-6600
Mailing Address - Street 1:3833 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3828
Mailing Address - Country:US
Mailing Address - Phone:718-984-6600
Mailing Address - Fax:718-984-6601
Practice Address - Street 1:3833 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3828
Practice Address - Country:US
Practice Address - Phone:718-984-6600
Practice Address - Fax:718-984-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17028979333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy