Provider Demographics
NPI:1427045913
Name:RAM THAKUR ENTERPRISE INC.
Entity Type:Organization
Organization Name:RAM THAKUR ENTERPRISE INC.
Other - Org Name:VAN WYCK PRESCRIPTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-658-0012
Mailing Address - Street 1:8820B VAN WYCK EXPY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2831
Mailing Address - Country:US
Mailing Address - Phone:718-658-0012
Mailing Address - Fax:718-297-5600
Practice Address - Street 1:88-20B VAN WYCK EXPY
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2831
Practice Address - Country:US
Practice Address - Phone:718-658-0012
Practice Address - Fax:718-297-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022853332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01611389Medicaid
NY3312509OtherNABP
NY3312509OtherNABP