Provider Demographics
NPI:1467238733
Name:SEGUINE HEALTH INC
Entity Type:Organization
Organization Name:SEGUINE HEALTH INC
Other - Org Name:SEGUINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-838-6115
Mailing Address - Street 1:27 SEGUINE AVE # STORE4
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3720
Mailing Address - Country:US
Mailing Address - Phone:347-838-6115
Mailing Address - Fax:347-838-6117
Practice Address - Street 1:27 SEGUINE AVE # STORE4
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3720
Practice Address - Country:US
Practice Address - Phone:347-838-6115
Practice Address - Fax:347-838-6117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy