Provider Demographics
NPI:1033654124
Name:HARVARD PHARMACY INC
Entity Type:Organization
Organization Name:HARVARD PHARMACY INC
Other - Org Name:COLONY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SP
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHANSIMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-439-5556
Mailing Address - Street 1:481 MIDDLE NECK RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1470
Mailing Address - Country:US
Mailing Address - Phone:516-439-5556
Mailing Address - Fax:516-439-5557
Practice Address - Street 1:481 MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1470
Practice Address - Country:US
Practice Address - Phone:516-439-5556
Practice Address - Fax:516-439-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0351723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy