Provider Demographics
NPI:1558357541
Name:DBG SECURITY DRUGS INC.
Entity Type:Organization
Organization Name:DBG SECURITY DRUGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NATWAR
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEVARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-654-6974
Mailing Address - Street 1:3419 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2501
Mailing Address - Country:US
Mailing Address - Phone:718-654-6974
Mailing Address - Fax:718-882-4648
Practice Address - Street 1:3419 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2501
Practice Address - Country:US
Practice Address - Phone:718-654-6974
Practice Address - Fax:718-882-4648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3329554OtherNCPDP NUMBER
NY01912665Medicaid
NY01912665Medicaid