Provider Demographics
NPI:1437304698
Name:PRESTIGE DRUGS INC.
Entity Type:Organization
Organization Name:PRESTIGE DRUGS INC.
Other - Org Name:NEW NEIGHBORHOOD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:IVRAGHIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-361-6060
Mailing Address - Street 1:4512 GREENPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2410
Mailing Address - Country:US
Mailing Address - Phone:718-361-6060
Mailing Address - Fax:718-361-3119
Practice Address - Street 1:4512 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-2410
Practice Address - Country:US
Practice Address - Phone:718-361-6060
Practice Address - Fax:718-361-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6194230001Medicare NSC