National Provider Identifier Database

AVALON GARDENS REHABILITATION HEALTH CARE CTR LLC
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

AVALON GARDENS REHABILITATION & HEALTH CARE CTR LLC
7 ROUTE 25A
SMITHTOWN, NY11787-1626
Phone: 631-724-2200
Fax: 631-724-2909
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X
Institutional Pharmacy 3336I0012X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for AVALON GARDENS REHABILITATION & HEALTH CARE CTR LLC

NPI Number 1003920992
Legal business name
LBN
AVALON GARDENS REHABILITATION & HEALTH CARE CTR LLC
Authorized official SUSAN OCONNOR - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 08/18/2006
Last updated 09/23/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 026282
  • NY Medicaid: 02569895
  • Other: 2063005 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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