Provider Demographics
NPI:1154867752
Name:FIRST AVENUE DRUGS INC
Entity Type:Organization
Organization Name:FIRST AVENUE DRUGS INC
Other - Org Name:ABC DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:646-750-3744
Mailing Address - Street 1:1925 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4483
Mailing Address - Country:US
Mailing Address - Phone:347-750-5540
Mailing Address - Fax:347-750-5541
Practice Address - Street 1:1925 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4483
Practice Address - Country:US
Practice Address - Phone:347-750-5540
Practice Address - Fax:347-750-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0351053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035105OtherNY STATE PHARMACY LICENSE NUMBER