Organization · NPI-2

5th Ave Drug, INC

Pharmacy · Bay Shore, NY

NPI number1659369783
StatusActive
Last updated in NPPESJul 9, 2026

Details

NPI
1659369783
Entity type
Organization (NPI-2)
Legal business name
5th Ave Drug, INC
Organization subpart
No
Enumeration date
Oct 12, 2005
Certification date
Jul 9, 2026
Last updated
Jul 9, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
333600000X Pharmacy020130NYYes
332B00000X Durable Medical Equipment & Medical Supplies–NY

Other names

  • Salumed 5th Avenue Pharmacy (Doing Business As)

Practice location

1805 5th Ave
Suite B
Bay Shore, NY 11706-1761

Phone 631-231-4960 · Fax 631-231-0368

Mailing address

1805 B Fifth Ave.
Bay Shore, NY 11706

Phone 631-231-4960 · Fax 631-231-0368

Authorized official

Tomas Diaz
President
6312314960

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