Provider Demographics
NPI:1821139031
Name:CORONA FARMACIA INC
Entity Type:Organization
Organization Name:CORONA FARMACIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-500-4891
Mailing Address - Street 1:20116 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2135
Mailing Address - Country:US
Mailing Address - Phone:718-500-4891
Mailing Address - Fax:332-777-1028
Practice Address - Street 1:20116 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2135
Practice Address - Country:US
Practice Address - Phone:718-500-4891
Practice Address - Fax:332-777-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02137391Medicaid
NY024244OtherPHARMACY LICENSE
NY3305477OtherNABP NUMBER