Provider Demographics
NPI:1467699637
Name:PHARMACY PLUS SURGICAL SUPPLIES INC
Entity Type:Organization
Organization Name:PHARMACY PLUS SURGICAL SUPPLIES INC
Other - Org Name:PHARMACY PLUS SURGICAL SUPPLIES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:FAKHRUL
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:718-430-0911
Mailing Address - Street 1:1770 WESTCHESTER AVE # D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3022
Mailing Address - Country:US
Mailing Address - Phone:718-430-0911
Mailing Address - Fax:718-430-0995
Practice Address - Street 1:1770 WESTCHESTER AVE # D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3022
Practice Address - Country:US
Practice Address - Phone:516-987-1521
Practice Address - Fax:718-430-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0292423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3101728Medicaid
2118626OtherPK
NY3101728Medicaid