Provider Demographics
NPI:1821102807
Name:HEALTH CITY PHARMACY CORP
Entity Type:Organization
Organization Name:HEALTH CITY PHARMACY CORP
Other - Org Name:ABC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN HOK DOON
Authorized Official - Middle Name:
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-267-8882
Mailing Address - Street 1:10 BOWERY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5101
Mailing Address - Country:US
Mailing Address - Phone:212-267-8882
Mailing Address - Fax:212-267-8881
Practice Address - Street 1:10 BOWERY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5101
Practice Address - Country:US
Practice Address - Phone:212-267-8882
Practice Address - Fax:212-267-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0270383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2063350OtherPK
NY02624028Medicaid
2063350OtherPK