Organization
ACARIAHEALTH PHARMACY 12 INC
Active
Other names
AcariaHealth Pharmacy #12
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA CICCOLELLA-KAHL (PRESIDENT)
(855) 422-2742
Entity
Organization
Contact information
Practice address
5 SKYLINE DR STE 240, HAWTHORNE, NY 10532-2166
(800) 511-5144
(866) 834-8523
Mailing address
PO BOX 956780, SAINT LOUIS, MO 63195-6780
(855) 422-2742
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
3336S0011X
Specialty Pharmacy
022156100
OH
3336S0011X
Specialty Pharmacy
Primary
030446
NY
3336S0011X
Specialty Pharmacy
036.0086823
VT
3336S0011X
Specialty Pharmacy
14829
SC
3336S0011X
Specialty Pharmacy
27747
TX
3336S0011X
Specialty Pharmacy
28RO00060600
NJ
3336S0011X
Specialty Pharmacy
8788455-1708
UT
3336S0011X
Specialty Pharmacy
MO0560285
WV
3336S0011X
Specialty Pharmacy
MO40001550
ME
3336S0011X
Specialty Pharmacy
NP000271
PA
3336S0011X
Specialty Pharmacy
NR0859
NH
3336S0011X
Specialty Pharmacy
PCN.0002265
CT
3336S0011X
Specialty Pharmacy
PH02751
NV
3336S0011X
Specialty Pharmacy
PHN10492
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054586
—
OH
05
—
0287865
—
NJ
05
—
1021594
—
VT
05
—
103040076 0001
—
PA
05
—
1811206071
—
CT
05
—
1811206071
—
TN
05
—
1811206071
—
UT
01
—
2133866
PK
—
05
—
3094449
—
NH
05
—
3262360
—
NY
05
—
7N0446
—
SC
Enumeration date
10/05/2010
Last updated
02/25/2024
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