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Organization
SURFSIDE CHEMISTS
Active
Organization
SURFSIDE CHEMISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD FOX (PRESIDENT)
(516) 432-4816
Entity
Organization
Contact information
Practice address
1079 W BEECH ST, EAST ATLANTIC BEACH, NY 11561-1115
(516) 432-4816
(516) 432-4853
Mailing address
191 LAGOON DR E, LIDO BEACH, NY 11561-4912
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
015178
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00331168
—
NY
01
—
3302976
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
07/20/2007
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