Provider Demographics
NPI:1306393202
Name:CAREX PHARMACY INC
Entity Type:Organization
Organization Name:CAREX PHARMACY INC
Other - Org Name:LYDIG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-678-8700
Mailing Address - Street 1:742 LYDIG AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2104
Mailing Address - Country:US
Mailing Address - Phone:718-678-8700
Mailing Address - Fax:718-678-8777
Practice Address - Street 1:742 LYDIG AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2104
Practice Address - Country:US
Practice Address - Phone:718-678-8700
Practice Address - Fax:718-678-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0350223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167013OtherPK
NY4623832Medicaid