Provider Demographics
NPI:1114965787
Name:HILLSIDE CHEMISTS INC.
Entity Type:Organization
Organization Name:HILLSIDE CHEMISTS INC.
Other - Org Name:HILLSIDE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAJMUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-658-7800
Mailing Address - Street 1:18420 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4858
Mailing Address - Country:US
Mailing Address - Phone:718-658-7800
Mailing Address - Fax:718-658-7999
Practice Address - Street 1:18420 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4858
Practice Address - Country:US
Practice Address - Phone:718-658-7800
Practice Address - Fax:718-658-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00777211Medicaid
NY00777211Medicaid