Provider Demographics
NPI:1659626745
Name:JACKSON HEIGHTS DRUGS INC.
Entity Type:Organization
Organization Name:JACKSON HEIGHTS DRUGS INC.
Other - Org Name:BANGLADESH FARMACIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-406-9393
Mailing Address - Street 1:7510 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6536
Mailing Address - Country:US
Mailing Address - Phone:718-406-9393
Mailing Address - Fax:718-406-9339
Practice Address - Street 1:7510 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6536
Practice Address - Country:US
Practice Address - Phone:718-406-9393
Practice Address - Fax:718-406-9339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336H0001X, 3336S0011X, 335E00000X
NY031381332B00000X, 332BP3500X, 333600000X, 3336C0003X, 3336S0011X, 335G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
No335G00000XSuppliersMedical Foods Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03488960Medicaid