Provider Demographics
NPI:1275716979
Name:1 STOP PHARMACY & FOOD MART.INC
Entity Type:Organization
Organization Name:1 STOP PHARMACY & FOOD MART.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YARDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-899-8200
Mailing Address - Street 1:7117 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6136
Mailing Address - Country:US
Mailing Address - Phone:718-899-8200
Mailing Address - Fax:718-899-8202
Practice Address - Street 1:7117 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6136
Practice Address - Country:US
Practice Address - Phone:718-899-8200
Practice Address - Fax:718-899-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6055140001Medicare NSC