Provider Demographics
NPI:1548482680
Name:CENTRAL PARK WEST AL CHEMISTS INC
Entity type:Organization
Organization Name:CENTRAL PARK WEST AL CHEMISTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/AO
Authorized Official - Prefix:
Authorized Official - First Name:AZMAT
Authorized Official - Middle Name:
Authorized Official - Last Name:REHMAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-377-8391
Mailing Address - Street 1:25 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7253
Mailing Address - Country:US
Mailing Address - Phone:212-247-8080
Mailing Address - Fax:212-265-2508
Practice Address - Street 1:25 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7253
Practice Address - Country:US
Practice Address - Phone:212-247-8080
Practice Address - Fax:212-265-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NY0282553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2062855OtherPK