Provider Demographics
NPI:1083640411
Name:MORALES PHARMACY INC.
Entity Type:Organization
Organization Name:MORALES PHARMACY INC.
Other - Org Name:MOSCOSO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:R-PH
Authorized Official - Phone:718-293-5832
Mailing Address - Street 1:151 EAST 170TH STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-7014
Mailing Address - Country:US
Mailing Address - Phone:718-293-5832
Mailing Address - Fax:718-293-6349
Practice Address - Street 1:151 E 170TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-7014
Practice Address - Country:US
Practice Address - Phone:718-293-5832
Practice Address - Fax:718-293-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0172293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00642791Medicaid
NY1074630001Medicare NSC