Provider Demographics
NPI:1144220427
Name:DELMAR DRUGS INC
Entity type:Organization
Organization Name:DELMAR DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:H
Authorized Official - Last Name:LIPP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-648-5999
Mailing Address - Street 1:589 AVENUE Z
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6346
Mailing Address - Country:US
Mailing Address - Phone:718-648-5999
Mailing Address - Fax:718-769-4295
Practice Address - Street 1:589 AVENUE Z
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6346
Practice Address - Country:US
Practice Address - Phone:718-648-5999
Practice Address - Fax:718-769-4295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018208333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3380350OtherNABP
NY00840006Medicaid
NY4773480001Medicare NSC