Provider Demographics
NPI:1992810907
Name:METRO DRUGS 3RD AVE CORP
Entity type:Organization
Organization Name:METRO DRUGS 3RD AVE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-627-2300
Mailing Address - Street 1:243 E 60TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1450
Mailing Address - Country:US
Mailing Address - Phone:212-794-7200
Mailing Address - Fax:212-794-7230
Practice Address - Street 1:243 E 60TH ST FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1450
Practice Address - Country:US
Practice Address - Phone:212-794-7200
Practice Address - Fax:212-794-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0211083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2067172OtherPK
NY01805792Medicaid