Provider Demographics
NPI:1518489038
Name:NEW WORLD PHARMACY INC
Entity Type:Organization
Organization Name:NEW WORLD PHARMACY INC
Other - Org Name:NEW WORLD PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEIYI
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-961-8292
Mailing Address - Street 1:136-20 ROOSEVELT AVENUE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-961-8292
Mailing Address - Fax:718-961-8295
Practice Address - Street 1:13620 ROOSEVELT AVE STE 107
Practice Address - Street 2:SUITE 107
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5668
Practice Address - Country:US
Practice Address - Phone:718-961-8292
Practice Address - Fax:718-961-8295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0355863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170745OtherPK
NY04891310Medicaid