Provider Demographics
NPI:1215398086
Name:CLEAR PHARMACY INC
Entity Type:Organization
Organization Name:CLEAR PHARMACY INC
Other - Org Name:CLEAR PHARMACY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARKHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HASANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-975-7680
Mailing Address - Street 1:1707 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1207
Mailing Address - Country:US
Mailing Address - Phone:718-975-7680
Mailing Address - Fax:718-975-7681
Practice Address - Street 1:1707 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1207
Practice Address - Country:US
Practice Address - Phone:718-975-7680
Practice Address - Fax:718-975-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
NY0344113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158586OtherPK
2158586OtherPK