Provider Demographics
NPI:1003115197
Name:DB MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:DB MEDICAL SUPPLIES INC
Other - Org Name:CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RADHAKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATRAGADDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-455-5558
Mailing Address - Street 1:979 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3204
Mailing Address - Country:US
Mailing Address - Phone:718-455-5558
Mailing Address - Fax:347-590-7212
Practice Address - Street 1:979 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3204
Practice Address - Country:US
Practice Address - Phone:718-455-5558
Practice Address - Fax:347-590-7212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0305443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129517OtherPK
NY3331844Medicaid
NY3331844Medicaid