Provider Demographics
NPI:1972233195
Name:PELHAM CITY PHARMACY INC
Entity type:Organization
Organization Name:PELHAM CITY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-751-7171
Mailing Address - Street 1:2092 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1412
Mailing Address - Country:US
Mailing Address - Phone:718-942-4888
Mailing Address - Fax:718-942-4889
Practice Address - Street 1:2092 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1412
Practice Address - Country:US
Practice Address - Phone:718-942-4888
Practice Address - Fax:718-942-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy