Provider Demographics
NPI:1639951965
Name:LINCOLN PLACE PHARMACY INC
Entity Type:Organization
Organization Name:LINCOLN PLACE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAJMUT
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-756-1717
Mailing Address - Street 1:1135 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1135 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4107
Practice Address - Country:US
Practice Address - Phone:718-756-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy