Provider Demographics
NPI:1346720265
Name:LORRAINE PHARMACY INC
Entity Type:Organization
Organization Name:LORRAINE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODSHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-522-5522
Mailing Address - Street 1:72 LORRAINE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2223
Mailing Address - Country:US
Mailing Address - Phone:718-522-5522
Mailing Address - Fax:718-522-5521
Practice Address - Street 1:72 LORRAINE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-2223
Practice Address - Country:US
Practice Address - Phone:718-522-5522
Practice Address - Fax:718-522-5521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy