Provider Demographics
NPI:1740221175
Name:CROWN PHARMACY INC
Entity Type:Organization
Organization Name:CROWN PHARMACY INC
Other - Org Name:CROWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUP PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-384-8145
Mailing Address - Street 1:17 EDISON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4201
Mailing Address - Country:US
Mailing Address - Phone:631-634-8145
Mailing Address - Fax:
Practice Address - Street 1:4020 82ND ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1305
Practice Address - Country:US
Practice Address - Phone:718-334-0800
Practice Address - Fax:718-334-0869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0275603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2067342OtherPK
NY02710603Medicaid
5566760001Medicare NSC