Provider Demographics
NPI:1134635444
Name:QK PHARMACY, INC.
Entity Type:Organization
Organization Name:QK PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PENG
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-762-3777
Mailing Address - Street 1:13617 39TH AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5504
Mailing Address - Country:US
Mailing Address - Phone:718-762-3777
Mailing Address - Fax:877-757-4276
Practice Address - Street 1:13617 39TH AVE STE 1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5504
Practice Address - Country:US
Practice Address - Phone:718-762-3777
Practice Address - Fax:877-757-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy