Provider Demographics
NPI:1699219097
Name:EBA DRUG CORP
Entity Type:Organization
Organization Name:EBA DRUG CORP
Other - Org Name:FINE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLGHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-421-8161
Mailing Address - Street 1:1490 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2436
Mailing Address - Country:US
Mailing Address - Phone:718-421-8161
Mailing Address - Fax:718-421-8160
Practice Address - Street 1:1490 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2436
Practice Address - Country:US
Practice Address - Phone:718-421-8161
Practice Address - Fax:718-421-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy