Provider Demographics
NPI:1194788612
Name:E S PHARMACY INC
Entity type:Organization
Organization Name:E S PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:KARVOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-438-6602
Mailing Address - Street 1:23 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877
Mailing Address - Country:US
Mailing Address - Phone:203-438-6600
Mailing Address - Fax:203-438-0305
Practice Address - Street 1:23 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4687
Practice Address - Country:US
Practice Address - Phone:203-438-6600
Practice Address - Fax:203-438-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCY.00000233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004199958Medicaid
1998742OtherPK