Provider Demographics
NPI:1750689881
Name:NEO PHARMACY INC
Entity Type:Organization
Organization Name:NEO PHARMACY INC
Other - Org Name:NEO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-618-3932
Mailing Address - Street 1:785 E 163RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7208
Mailing Address - Country:US
Mailing Address - Phone:718-991-7901
Mailing Address - Fax:718-991-7821
Practice Address - Street 1:785 E 163RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7208
Practice Address - Country:US
Practice Address - Phone:718-991-7901
Practice Address - Fax:718-991-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0305653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5802144OtherNCPDP PROVIDER IDENTIFICATION NUMBER
5802144OtherNCPDP PROVIDER IDENTIFICATION NUMBER