Provider Demographics
NPI:1629147012
Name:SHIMONS PHARMACY INC
Entity Type:Organization
Organization Name:SHIMONS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHANTEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-384-0234
Mailing Address - Street 1:115 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7904
Mailing Address - Country:US
Mailing Address - Phone:718-384-0234
Mailing Address - Fax:718-384-3910
Practice Address - Street 1:115 LEE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7904
Practice Address - Country:US
Practice Address - Phone:718-384-0234
Practice Address - Fax:718-384-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0247613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy