Provider Demographics
NPI:1831187202
Name:RLJ PHARMACY INC
Entity type:Organization
Organization Name:RLJ PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPV PHCIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-232-3200
Mailing Address - Street 1:294 KATONAH AVE
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2148
Mailing Address - Country:US
Mailing Address - Phone:914-232-3200
Mailing Address - Fax:914-232-3505
Practice Address - Street 1:294 KATONAH AVE
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2148
Practice Address - Country:US
Practice Address - Phone:914-232-3200
Practice Address - Fax:914-232-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0246413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02316723Medicaid
3371729OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3371729OtherNCPDP PROVIDER IDENTIFICATION NUMBER