4TH AVE DRUG STORE INC (NPI# 1295299535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295299535 |
| Entity Type | Organization |
| Organization Name | 4TH AVE DRUG STORE INC |
| Practice Address |
26 S 4th Ave Mount Vernon NY 10550-3105 |
| Practice Telephone | 9148630399 |
| Practice Fax Number | 9148630397 |
| Mailing Telephone | 9148630399 |
| Mailing Fax Number | 9148630397 |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | BIBI ESAHACK (PRESIDENT) |
| Authorized Official Telephone | 9148630399 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Street Address |
26 S 4TH AVE |
| City | MOUNT VERNON |
| State | NY |
| Zip Code | 10550-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487240 | Jacqueline Marshall | Technician | 144 South 2nd Avenue 2c, Mount Vernon, West Chester, NY 10550 | 2020-05-05 |
| 1023529369 | B.t.m. Psychiatric Np Services, Pllc | Nurse Practitioner | 11 W Prospect Ave, 3rd Fl, Suite #5b, Mount Vernon, NY 10550 | 2017-10-13 |
| 1669994174 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 500 E Sanford Blvd, Mount Vernon, NY 10550 | 2017-07-17 |
| 1053869198 | Teresa Turriago I | Social Worker | 487 S. Broadway, Yonkers, New York, NY 10550 | 2016-09-19 |
| 1811340862 | Marcia Samuels Nembhard | Licensed Practical Nurse | 1 Gray Place Apt 4-d, Mount Vernon, NY 10550 | 2016-07-14 |
| 1043665318 | Marshalee Mullings | Registered Nurse | 70 E 4th Street, 2c, Mount Vernon, NY 10550 | 2016-04-25 |
| 1518333228 | Humanities Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 100 Stevens Avenue, Mount Vernon, NY 10550 | 2015-08-17 |
| 1851779458 | Maila Catolico | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-05-14 |
| 1003203266 | Priscilla A. Severe | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-04-24 |
| 1477963254 | Imani Ife Campbell | Licensed Practical Nurse | 323 South 10th Ave, Mt. Vernon, NY 10550 | 2014-05-02 |
| Find all providers in zip 10550 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114545571 | Medlife Pharmacy LLC | Pharmacy | 213 Highway 37 Ste 200&300, Mount Vernon, TX 75457-3106 | 2020-07-10 |
| 1396175345 | Allcare PC | Pharmacy | 115 Spring St, Mount Vernon, GA 30445 | 2013-11-12 |
| 1811040918 | Brown & Cole Stores LLC | Pharmacy | 1515 N 18th St, Mount Vernon, WA 98273-2675 | 2007-01-19 |
| 1649374695 | Marco Pharmacy and Optical Inc | Pharmacy | 4121 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2006-09-12 |
| 1992808695 | Hook Superx LLC | Pharmacy | 700 E 4th St, Mount Vernon, IN 47620-2011 | 2006-09-07 |
| 1467555235 | Highland Park Cvs, L.L.C. | Pharmacy | 2700 Broadway St, Mount Vernon, IL 62864-2342 | 2006-09-07 |
| 1316970650 | Haggen, Inc | Pharmacy | 2601 E Division St, Mount Vernon, WA 98274-4748 | 2006-07-09 |
| 1417923012 | Mt Vernon Community Pharmacy Inc | Pharmacy | 2339 Broadway St, Mount Vernon, IL 62864-2925 | 2006-02-24 |
| 1619592763 | Knox Community Hospital | Pharmacy | 1330 Coshocton Ave, Mount Vernon, OH 43050-1495 | 2020-06-15 |
| 1639644156 | Mabd Enterprises, LLC | Pharmacy | 115 W Spring St, Mount Vernon, GA 30445-2957 | 2018-10-11 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 10550 |
Please comment or provide details below to improve the information on 4TH AVE DRUG STORE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.