Provider Demographics
NPI:1770998635
Name:ECKERSON PHARMACY CORP.
Entity type:Organization
Organization Name:ECKERSON PHARMACY CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARUPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:BSPHARMACY
Authorized Official - Phone:240-498-2151
Mailing Address - Street 1:200 E ECKERSON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7153
Mailing Address - Country:US
Mailing Address - Phone:845-425-1131
Mailing Address - Fax:845-425-8035
Practice Address - Street 1:200 E ECKERSON RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-7153
Practice Address - Country:US
Practice Address - Phone:845-425-1131
Practice Address - Fax:845-425-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy