Provider Demographics
NPI:1083948129
Name:1622 VOORHIES AVE PHARMACY INC
Entity Type:Organization
Organization Name:1622 VOORHIES AVE PHARMACY INC
Other - Org Name:SUNSHINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VINBAYTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-260-4878
Mailing Address - Street 1:1622 VOORHIES AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:347-462-9778
Mailing Address - Fax:347-462-9781
Practice Address - Street 1:1622 VOORHIES AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:347-462-9778
Practice Address - Fax:347-462-9781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6337860001Medicare NSC