# SHORE PHARMACEUTICAL PROVIDERS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OMNICAREESC LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134441686
- **Legal business name:** OMNICAREESC LLC
- **Authorized official:** MR. IVAN GORDON (CEO)
- **Authorized official phone:** (516) 938-8080

## Contact information

- **Practice address:** 24812 82ND AVE, BELLEROSE, NY 11426-2502
- **Practice address phone:** (718) 347-4844
- **Mailing address:** 24812 82ND AVE, BELLEROSE, NY 11426-2502
- **Mailing address phone:** (718) 347-4844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 33065 | NY | Yes |

## Other

- **Enumeration date:** 02/25/2010
- **Last updated:** 03/03/2010