Provider Demographics
NPI:1518558048
Name:AMAYA PHARMACY CORP
Entity Type:Organization
Organization Name:AMAYA PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-362-3336
Mailing Address - Street 1:14075 ASH AVE OFC 2C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2789
Mailing Address - Country:US
Mailing Address - Phone:718-352-3300
Mailing Address - Fax:
Practice Address - Street 1:14075 ASH AVE OFC 2C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2789
Practice Address - Country:US
Practice Address - Phone:718-352-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy