Provider Demographics
NPI:1093075327
Name:A & J PHARMACY AND SURGICAL SUPPLIES INC
Entity Type:Organization
Organization Name:A & J PHARMACY AND SURGICAL SUPPLIES INC
Other - Org Name:A & J PHARMACY & SURGICAL SUPPLIES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-376-6505
Mailing Address - Street 1:13108 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-3124
Mailing Address - Country:US
Mailing Address - Phone:718-323-3700
Mailing Address - Fax:718-323-3705
Practice Address - Street 1:13108 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-3124
Practice Address - Country:US
Practice Address - Phone:718-323-3700
Practice Address - Fax:718-323-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0312753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135487OtherPK