Provider Demographics
NPI:1174824353
Name:ADINAS PHARMACY INC
Entity Type:Organization
Organization Name:ADINAS PHARMACY INC
Other - Org Name:ADINA'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-739-9700
Mailing Address - Street 1:13819 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2641
Mailing Address - Country:US
Mailing Address - Phone:718-739-9700
Mailing Address - Fax:718-739-9777
Practice Address - Street 1:13819 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-2641
Practice Address - Country:US
Practice Address - Phone:718-739-9700
Practice Address - Fax:718-739-9777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0304373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5801394OtherNCPDP PROVIDER IDENTIFICATION NUMBER