Provider Demographics
NPI:1659646966
Name:MEERAJ PHARMACY INC.
Entity Type:Organization
Organization Name:MEERAJ PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:IQRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:718-641-4400
Mailing Address - Street 1:11517 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1901
Mailing Address - Country:US
Mailing Address - Phone:718-641-4400
Mailing Address - Fax:718-641-4401
Practice Address - Street 1:11517 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1901
Practice Address - Country:US
Practice Address - Phone:718-641-4400
Practice Address - Fax:718-641-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6691250001Medicare NSC
NY6691250001Medicare NSC