Provider Demographics
NPI:1568765196
Name:SAN REMO SUPER PHARMACY INC.
Entity Type:Organization
Organization Name:SAN REMO SUPER PHARMACY INC.
Other - Org Name:SAN REMO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-265-6404
Mailing Address - Street 1:629 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-3407
Mailing Address - Country:US
Mailing Address - Phone:631-265-6404
Mailing Address - Fax:631-265-6094
Practice Address - Street 1:629 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-3407
Practice Address - Country:US
Practice Address - Phone:631-265-6404
Practice Address - Fax:631-265-6094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy