Provider Demographics
NPI:1093340341
Name:ALIZACELINA INC.
Entity Type:Organization
Organization Name:ALIZACELINA INC.
Other - Org Name:BRIGHT CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAHIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-401-2820
Mailing Address - Street 1:430 E 149TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1338
Mailing Address - Country:US
Mailing Address - Phone:718-401-2820
Mailing Address - Fax:718-401-2805
Practice Address - Street 1:430 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1338
Practice Address - Country:US
Practice Address - Phone:718-401-2820
Practice Address - Fax:718-401-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy