Provider Demographics
NPI:1316956642
Name:DRUG MART OF BEDFORD HILLS INC.
Entity type:Organization
Organization Name:DRUG MART OF BEDFORD HILLS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-666-6565
Mailing Address - Street 1:737 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1524
Mailing Address - Country:US
Mailing Address - Phone:914-666-6565
Mailing Address - Fax:914-666-4446
Practice Address - Street 1:737 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1524
Practice Address - Country:US
Practice Address - Phone:914-666-6565
Practice Address - Fax:914-666-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02523215Medicaid
NY02523215Medicaid