Provider Demographics
NPI:1093870693
Name:UPGRADE PHARMACY INC
Entity Type:Organization
Organization Name:UPGRADE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAFDAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-665-9179
Mailing Address - Street 1:679 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-3307
Mailing Address - Country:US
Mailing Address - Phone:718-665-9179
Mailing Address - Fax:718-665-9192
Practice Address - Street 1:679 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3307
Practice Address - Country:US
Practice Address - Phone:718-665-9179
Practice Address - Fax:718-665-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033155183500000X
NY033155-1332B00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3386845OtherNABP
NY00944216Medicaid
NY0952340001Medicare NSC