Provider Demographics
NPI:1619411493
Name:MULBERRY PHARMACY INC
Entity Type:Organization
Organization Name:MULBERRY PHARMACY INC
Other - Org Name:MULBERRY PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOI
Authorized Official - Middle Name:DAC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-693-6688
Mailing Address - Street 1:87 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4452
Mailing Address - Country:US
Mailing Address - Phone:212-693-6688
Mailing Address - Fax:212-693-6677
Practice Address - Street 1:87 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4452
Practice Address - Country:US
Practice Address - Phone:212-693-6688
Practice Address - Fax:212-693-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy