Provider Demographics
NPI:1326122458
Name:SNVK PHARMACY INC
Entity Type:Organization
Organization Name:SNVK PHARMACY INC
Other - Org Name:WEST ST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER / PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHINKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-364-2800
Mailing Address - Street 1:47 W 183RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-1233
Mailing Address - Country:US
Mailing Address - Phone:718-364-2800
Mailing Address - Fax:718-365-0537
Practice Address - Street 1:47 W 183RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1233
Practice Address - Country:US
Practice Address - Phone:718-364-2800
Practice Address - Fax:718-365-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0256113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02354447Medicaid
2067719OtherPK
4790760001Medicare NSC