Provider Demographics
NPI:1588374086
Name:MERU PHARMACY INC
Entity type:Organization
Organization Name:MERU PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:PRAVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:914-964-1010
Mailing Address - Street 1:2 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-3402
Mailing Address - Country:US
Mailing Address - Phone:914-964-1010
Mailing Address - Fax:914-964-0055
Practice Address - Street 1:2 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-3402
Practice Address - Country:US
Practice Address - Phone:914-964-1010
Practice Address - Fax:914-964-0055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERU PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02358336Medicaid