Provider Demographics
NPI:1043304454
Name:PHARMACIA POPULAR INC
Entity Type:Organization
Organization Name:PHARMACIA POPULAR INC
Other - Org Name:PHARMACIA POPULAR INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:RASHED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-218-9346
Mailing Address - Street 1:17 MARCUS GARVEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5335
Mailing Address - Country:US
Mailing Address - Phone:718-218-9346
Mailing Address - Fax:718-218-9435
Practice Address - Street 1:17 MARCUS GARVEY BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5335
Practice Address - Country:US
Practice Address - Phone:718-218-9346
Practice Address - Fax:718-218-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
NY0262273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02439123Medicaid
2060636OtherPK
4965280001Medicare NSC