Provider Demographics
NPI:1407375389
Name:DELTA PHARMACY INC.
Entity Type:Organization
Organization Name:DELTA PHARMACY INC.
Other - Org Name:DELTA PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HISBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PRECIL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:646-642-2035
Mailing Address - Street 1:1270 BARRY DR S
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4202 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3012
Practice Address - Country:US
Practice Address - Phone:347-663-3944
Practice Address - Fax:347-663-3943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI049966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty