Provider Demographics
NPI:1538549027
Name:SPECIALTY CHEMIST CORP.
Entity type:Organization
Organization Name:SPECIALTY CHEMIST CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANUM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-869-5522
Mailing Address - Street 1:6560 FRESH MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2012
Mailing Address - Country:US
Mailing Address - Phone:718-353-2595
Mailing Address - Fax:718-886-8658
Practice Address - Street 1:6560 FRESH MEADOW LN
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2012
Practice Address - Country:US
Practice Address - Phone:718-353-2595
Practice Address - Fax:718-886-8658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy