Provider Demographics
NPI:1861516460
Name:EMPIRE DRUGS INC
Entity type:Organization
Organization Name:EMPIRE DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUISINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD RPH
Authorized Official - Phone:315-339-0648
Mailing Address - Street 1:1717 BLACK RIVER BLVD N
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2425
Mailing Address - Country:US
Mailing Address - Phone:315-339-0648
Mailing Address - Fax:315-337-5303
Practice Address - Street 1:37 CENTRAL PLZ
Practice Address - Street 2:
Practice Address - City:ILION
Practice Address - State:NY
Practice Address - Zip Code:13357-1701
Practice Address - Country:US
Practice Address - Phone:315-894-3333
Practice Address - Fax:315-894-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 332B00000X, 333600000X
NY0282253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02870175Medicaid
3353315OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3353315OtherNCPDP PROVIDER IDENTIFICATION NUMBER