Organization
255 COLUMBUS AVE CORP
Active
Other names
WEST SIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ESSOH CLAUDE ESSIMEL (PRESIDENT/OWNER)
(212) 362-9170
Entity
Organization
Contact information
Practice address
255 COLUMBUS AVE, NEW YORK, NY 10023-3330
(212) 362-9170
(212) 362-9478
Mailing address
255 COLUMBUS AVE, NEW YORK, NY 10023-3330
(212) 362-9170
(212) 362-9478
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
015922
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3363734
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/21/2007
Last updated
05/23/2024
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