Provider Demographics
NPI:1598322760
Name:DIRECT CONNECT PHARMACY INC
Entity Type:Organization
Organization Name:DIRECT CONNECT PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISING PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:646-226-0393
Mailing Address - Street 1:394 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3037
Mailing Address - Country:US
Mailing Address - Phone:646-226-0393
Mailing Address - Fax:
Practice Address - Street 1:394 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3037
Practice Address - Country:US
Practice Address - Phone:646-226-0393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy