Provider Demographics
NPI:1609850189
Name:NOHA PHARMACY INC.
Entity Type:Organization
Organization Name:NOHA PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:NEGM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-456-5475
Mailing Address - Street 1:291 KNICKERBOCKER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-3103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:291 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3103
Practice Address - Country:US
Practice Address - Phone:718-456-5475
Practice Address - Fax:718-501-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019736333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01058891Medicaid