Provider Demographics
NPI:1407144256
Name:5125 CHEMISTS CORP
Entity Type:Organization
Organization Name:5125 CHEMISTS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHEIRABI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:212-444-2265
Mailing Address - Street 1:5125 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4539
Mailing Address - Country:US
Mailing Address - Phone:212-444-2265
Mailing Address - Fax:
Practice Address - Street 1:5125 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4539
Practice Address - Country:US
Practice Address - Phone:212-444-2265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0531681333600000X, 3336C0003X, 3336C0004X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy