Provider Demographics
NPI:1114614500
Name:ZARCHY PHARMACY RX LLC
Entity Type:Organization
Organization Name:ZARCHY PHARMACY RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNJUKUNJU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-424-3286
Mailing Address - Street 1:5721 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3430
Mailing Address - Country:US
Mailing Address - Phone:718-424-3286
Mailing Address - Fax:
Practice Address - Street 1:5721 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3430
Practice Address - Country:US
Practice Address - Phone:718-424-3286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3303776OtherNCPDP