Vida Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028789 Issued in NY

Legal business name

VIDA PHARMACY, INC.

Practice address

1620 Saint Nicholas Ave
New York, NY 10040-3313

Phone

(212) 923-3524

Fax

(212) 923-3523

NPI assigned

Mar 20, 2008

Last updated

Mar 20, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gustavo Adolfo Arias

Title

President

Phone

(212) 923-3524

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1093986713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403313",
            "telephone_number": "212-923-3524",
            "fax_number": "212-923-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403313",
            "telephone_number": "212-923-3524",
            "fax_number": "212-923-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "ARIAS",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "ADOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-923-3524"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Physical Medicine PC
• Jacqueline Victoria-Kline, LMSW
• Daniel Victorio, MD
• Victory Medical Associates PC
• Vida Family Services, Inc.
• Alana Marie Vidal, MS, CF-SLP, TSSLD
• Grecia Milagros Vidal
• Laura V Vidal, LCSW
• Lilia Alexandra Vidal, LMSW
• Mariella Vidal, LMSW

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.