Provider Demographics
NPI:1518011964
Name:M DRUGS INC
Entity Type:Organization
Organization Name:M DRUGS INC
Other - Org Name:M DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHCST
Authorized Official - Prefix:
Authorized Official - First Name:JAMILEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-252-7334
Mailing Address - Street 1:405 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4611
Mailing Address - Country:US
Mailing Address - Phone:718-252-7334
Mailing Address - Fax:718-252-7336
Practice Address - Street 1:405 AVENUE M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4611
Practice Address - Country:US
Practice Address - Phone:718-252-7334
Practice Address - Fax:718-252-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NY0253183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02365002Medicaid
2064105OtherPK
NY02365002Medicaid