Provider Demographics
NPI:1518230309
Name:THRIFT PHARMACY LLC
Entity Type:Organization
Organization Name:THRIFT PHARMACY LLC
Other - Org Name:THRIFT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GAUTAM
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:NIRMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-282-4600
Mailing Address - Street 1:1621 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2615
Mailing Address - Country:US
Mailing Address - Phone:718-282-4600
Mailing Address - Fax:718-282-3815
Practice Address - Street 1:1621 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2615
Practice Address - Country:US
Practice Address - Phone:718-282-4600
Practice Address - Fax:718-282-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy