Provider Demographics
NPI:1730259995
Name:RICHMOND PHARMACY & SURGICALS INC.
Entity type:Organization
Organization Name:RICHMOND PHARMACY & SURGICALS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DROGARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPH
Authorized Official - Phone:718-447-1206
Mailing Address - Street 1:1796 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1672
Mailing Address - Country:US
Mailing Address - Phone:718-447-1206
Mailing Address - Fax:718-981-3638
Practice Address - Street 1:1796 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1672
Practice Address - Country:US
Practice Address - Phone:718-447-1206
Practice Address - Fax:718-981-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019959333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01111691Medicaid
NY0548550001Medicare NSC
NY0548550001Medicare ID - Type Unspecified