Provider Demographics
NPI:1255838249
Name:ALL GREEN PHARMACY LLC
Entity Type:Organization
Organization Name:ALL GREEN PHARMACY LLC
Other - Org Name:ALL GREEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUFIZUL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-660-0413
Mailing Address - Street 1:16829 HILLSIDE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4440
Mailing Address - Country:US
Mailing Address - Phone:917-660-0413
Mailing Address - Fax:
Practice Address - Street 1:16829 HILLSIDE AVE FL 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4440
Practice Address - Country:US
Practice Address - Phone:917-660-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332100000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies