Provider Demographics
NPI:1083796163
Name:PHARMAX INC
Entity Type:Organization
Organization Name:PHARMAX INC
Other - Org Name:MINH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LONG
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-343-1252
Mailing Address - Street 1:207 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4276
Mailing Address - Country:US
Mailing Address - Phone:212-343-1252
Mailing Address - Fax:
Practice Address - Street 1:207 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4276
Practice Address - Country:US
Practice Address - Phone:212-343-1252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0255843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3335557OtherNABP
NY02355113Medicaid
NY02355113Medicaid