Provider Demographics
NPI:1639316367
Name:BERKELEY DRUGS INC.
Entity Type:Organization
Organization Name:BERKELEY DRUGS INC.
Other - Org Name:BERKELEY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AWAIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-3434
Mailing Address - Street 1:1951 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2819
Mailing Address - Country:US
Mailing Address - Phone:718-338-3434
Mailing Address - Fax:718-258-1768
Practice Address - Street 1:1951 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2819
Practice Address - Country:US
Practice Address - Phone:718-338-3434
Practice Address - Fax:718-258-1768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0292583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03060822Medicaid
3359610OtherNCPDP
NY029258OtherSTATE LICENSE
NY029258OtherSTATE LICENSE
NY03060822Medicaid