Provider Demographics
NPI:1790094365
Name:URVI PHARMACY INC
Entity Type:Organization
Organization Name:URVI PHARMACY INC
Other - Org Name:NICK'S DRUGS STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NATWAR
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEVARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-590-1030
Mailing Address - Street 1:3060 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4038
Mailing Address - Country:US
Mailing Address - Phone:347-590-1030
Mailing Address - Fax:347-590-1029
Practice Address - Street 1:3060 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4038
Practice Address - Country:US
Practice Address - Phone:347-590-1030
Practice Address - Fax:347-590-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03298331Medicaid
NY6484490001Medicare NSC