Provider Demographics
NPI:1073534988
Name:K & F DRUG CORP.
Entity Type:Organization
Organization Name:K & F DRUG CORP.
Other - Org Name:STARSIDE DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-961-2931
Mailing Address - Street 1:4116 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3133
Mailing Address - Country:US
Mailing Address - Phone:718-886-1031
Mailing Address - Fax:718-886-0551
Practice Address - Street 1:4116 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3133
Practice Address - Country:US
Practice Address - Phone:718-886-1031
Practice Address - Fax:718-886-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0210643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01255325Medicaid
NY3399525OtherNABP
NY1253450001Medicare NSC