Provider Demographics
NPI:1487798518
Name:MARC'S VILLAGE PHARMACY, INC.
Entity type:Organization
Organization Name:MARC'S VILLAGE PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-592-8211
Mailing Address - Street 1:31 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2608
Mailing Address - Country:US
Mailing Address - Phone:914-592-8211
Mailing Address - Fax:914-592-8212
Practice Address - Street 1:31 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2608
Practice Address - Country:US
Practice Address - Phone:914-592-8211
Practice Address - Fax:914-592-8212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0390051333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1260680001Medicare NSC