Provider Demographics
NPI:1780639526
Name:UNIVERSAL PHARMACY INC
Entity Type:Organization
Organization Name:UNIVERSAL PHARMACY INC
Other - Org Name:SARA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IBRAR
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:NADEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-696-1500
Mailing Address - Street 1:652 E 233RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2802
Mailing Address - Country:US
Mailing Address - Phone:718-696-1500
Mailing Address - Fax:718-547-2646
Practice Address - Street 1:652 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2802
Practice Address - Country:US
Practice Address - Phone:718-696-1500
Practice Address - Fax:718-547-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0284073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2067740OtherPK
NY02740729Medicaid
NY02740729Medicaid
NY02861425Medicaid