Provider Demographics
NPI:1598844706
Name:CUTIE PHARMA-CARE, INC
Entity type:Organization
Organization Name:CUTIE PHARMA-CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOULTY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:518-692-8500
Mailing Address - Street 1:114 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-1215
Mailing Address - Country:US
Mailing Address - Phone:518-692-8500
Mailing Address - Fax:518-692-8552
Practice Address - Street 1:114 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-1215
Practice Address - Country:US
Practice Address - Phone:518-692-8500
Practice Address - Fax:518-692-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0254383336L0003X
NHNR03083336M0002X
MEME2444593336M0002X
VT036-00000353336M0002X
RIPH097573336M0002X
CT6493336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Not Answered3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02311782Medicaid
NY3327081OtherNCPDP
NY02311782Medicaid