Provider Demographics
NPI:1265597587
Name:VOGEL PHARMACY INC.
Entity type:Organization
Organization Name:VOGEL PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALICENTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS-PHARMACY
Authorized Official - Phone:845-831-3784
Mailing Address - Street 1:234 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-2732
Mailing Address - Country:US
Mailing Address - Phone:845-831-3784
Mailing Address - Fax:845-831-0065
Practice Address - Street 1:234 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2732
Practice Address - Country:US
Practice Address - Phone:845-831-3784
Practice Address - Fax:845-831-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00508296Medicaid
NY00508296Medicaid