Organization · NPI-2

1400 St Nicholas LLC

Pharmacy, Community/Retail Pharmacy · New York, NY

NPI number1417448945

StatusActive

Last updated in NPPESDec 18, 2023

Details

NPI: 1417448945
Entity type: Organization (NPI-2)
Legal business name: 1400 St Nicholas LLC
Organization subpart: No
Enumeration date: May 21, 2018
Certification date: Dec 18, 2023
Last updated: Dec 18, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	–	–	Yes
333600000X	Pharmacy	–	–

Other names

Safe Heart Pharmacy (Doing Business As)

Practice location

1400 Saint Nicholas Ave
New York, NY 10033-4027

Phone 212-568-5454 · Fax 212-568-5340

Mailing address

1400 Saint Nicholas Ave
New York, NY 10033-4027

Phone 212-568-5454 · Fax 212-568-5340

Authorized official

Maria Favale
Supervising Pharmacist
2125685454

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.