Organization
OLD TOWN PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INNA ICHTCHENKO (PRSIDENT)
(718) 815-2600
Entity
Organization
Contact information
Practice address
1250 HYLAN BLVD STE 3A, STATEN ISLAND, NY 10305-1944
(718) 815-2600
(718) 815-2095
Mailing address
1250 HYLAN BLVD, STATEN ISLAND, NY 10305-1943
(718) 815-2600
(718) 815-2095
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02664717
—
NY
Enumeration date
12/15/2006
Last updated
08/31/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us