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Organization
SHORE PHARMACEUTICAL PROVIDERS
Active
Organization
SHORE PHARMACEUTICAL PROVIDERS
Active
Parent organization
OMNICAREESC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OMNICAREESC LLC
Authorized official
MR. IVAN GORDON (CEO)
(516) 938-8080
Entity
Organization
Contact information
Practice address
24812 82ND AVE, BELLEROSE, NY 11426-2502
(718) 347-4844
Mailing address
24812 82ND AVE, BELLEROSE, NY 11426-2502
(718) 347-4844
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
33065
NY
Other
Enumeration date
02/25/2010
Last updated
03/03/2010
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