Provider Demographics
NPI:1578748919
Name:ALITA PHARMACY INC
Entity Type:Organization
Organization Name:ALITA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMEDALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-217-1424
Mailing Address - Street 1:191-19 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2521
Mailing Address - Country:US
Mailing Address - Phone:718-217-1424
Mailing Address - Fax:718-217-1425
Practice Address - Street 1:191-19 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2521
Practice Address - Country:US
Practice Address - Phone:718-217-1424
Practice Address - Fax:718-217-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028713333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6056430001Medicare NSC