Provider Demographics
NPI:1710315957
Name:CARE FAST PHARMACY INC
Entity Type:Organization
Organization Name:CARE FAST PHARMACY INC
Other - Org Name:CARE FAST PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLSHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-975-4464
Mailing Address - Street 1:3771 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2041
Mailing Address - Country:US
Mailing Address - Phone:718-975-4464
Mailing Address - Fax:718-975-4465
Practice Address - Street 1:3771 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2041
Practice Address - Country:US
Practice Address - Phone:718-975-4464
Practice Address - Fax:718-975-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0323193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142203OtherPK
7008950001Medicare NSC