Provider Demographics
NPI:1447090600
Name:PURECARE PHARMACY AND WELLNESS INC
Entity type:Organization
Organization Name:PURECARE PHARMACY AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIGDALOS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-277-2668
Mailing Address - Street 1:65 GLEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1007
Mailing Address - Country:US
Mailing Address - Phone:914-330-1499
Mailing Address - Fax:
Practice Address - Street 1:65 GLEN COVE RD
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1007
Practice Address - Country:US
Practice Address - Phone:914-330-1499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy