Provider Demographics
NPI:1508079625
Name:IMAGES PHARMACY INC.
Entity Type:Organization
Organization Name:IMAGES PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SARFRAZ
Authorized Official - Middle Name:HUSSAIN
Authorized Official - Last Name:SUBZWARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-455-5065
Mailing Address - Street 1:1383 BUSHWICK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1407
Mailing Address - Country:US
Mailing Address - Phone:718-455-5065
Mailing Address - Fax:718-455-9398
Practice Address - Street 1:1383 BUSHWICK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1407
Practice Address - Country:US
Practice Address - Phone:718-455-5065
Practice Address - Fax:718-455-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0200243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01114112Medicaid
NY5313830001Medicare NSC