Provider Demographics
NPI:1013548437
Name:HYLAN CARE PHARMA CORP
Entity Type:Organization
Organization Name:HYLAN CARE PHARMA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:SAYED
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-783-3502
Mailing Address - Street 1:1509 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1907
Mailing Address - Country:US
Mailing Address - Phone:917-783-3502
Mailing Address - Fax:
Practice Address - Street 1:1509 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1907
Practice Address - Country:US
Practice Address - Phone:917-783-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy