Provider Demographics
NPI:1902978794
Name:CAMDEN DRUGS INC
Entity Type:Organization
Organization Name:CAMDEN DRUGS INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-245-1410
Mailing Address - Street 1:58 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13316-1338
Mailing Address - Country:US
Mailing Address - Phone:315-245-1410
Mailing Address - Fax:315-245-3339
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NY
Practice Address - Zip Code:13316-1338
Practice Address - Country:US
Practice Address - Phone:315-245-1410
Practice Address - Fax:315-245-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016444333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00528794Medicaid
3366590OtherOTHER ID NUMBER-COMMERCIAL NUMBER
AC8666159OtherDEA
NYBB2311Medicare PIN
AC8666159OtherDEA