Provider Demographics
NPI: | 1619308343 |
---|---|
Name: | TAKE CARE PHARMACY INC. |
Entity Type: | Organization |
Organization Name: | TAKE CARE PHARMACY INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/SUPERVISING PHARMACIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ZANNATUL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FIRDOUSHI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 201-707-5704 |
Mailing Address - Street 1: | 2134 STARLING AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | BRONX |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10462-4303 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 347-281-9221 |
Mailing Address - Fax: | 347-281-9222 |
Practice Address - Street 1: | 2134 STARLING AVE |
Practice Address - Street 2: | |
Practice Address - City: | BRONX |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10462-4303 |
Practice Address - Country: | US |
Practice Address - Phone: | 347-281-9221 |
Practice Address - Fax: | 347-281-9222 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-12-05 |
Last Update Date: | 2023-04-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0003X | Suppliers | Pharmacy | Community/Retail Pharmacy |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 7185350001 | Medicare NSC |