Provider Demographics
NPI:1679182349
Name:MARVEL PHARMACY INC
Entity Type:Organization
Organization Name:MARVEL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:FARIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-880-2171
Mailing Address - Street 1:9612 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1624
Mailing Address - Country:US
Mailing Address - Phone:718-880-2171
Mailing Address - Fax:718-880-2134
Practice Address - Street 1:9612 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1624
Practice Address - Country:US
Practice Address - Phone:718-880-2171
Practice Address - Fax:718-880-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy