Provider Demographics
NPI:1093238180
Name:GOYDAN PHARMACY INC
Entity Type:Organization
Organization Name:GOYDAN PHARMACY INC
Other - Org Name:MAXWELL DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLISHTIYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-641-5010
Mailing Address - Street 1:150-29 CROSS BAY BLVD
Mailing Address - Street 2:STORE 1
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417
Mailing Address - Country:US
Mailing Address - Phone:718-641-5010
Mailing Address - Fax:718-641-5012
Practice Address - Street 1:150-29 CROSS BAY BLVD
Practice Address - Street 2:STORE 1
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417
Practice Address - Country:US
Practice Address - Phone:718-641-5010
Practice Address - Fax:718-641-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy