Provider Demographics
NPI:1821331422
Name:DJ DRUGS & SURGICALS INC.
Entity Type:Organization
Organization Name:DJ DRUGS & SURGICALS INC.
Other - Org Name:AHMA RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-749-6626
Mailing Address - Street 1:2381 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-1822
Mailing Address - Country:US
Mailing Address - Phone:212-749-6626
Mailing Address - Fax:212-749-6629
Practice Address - Street 1:2381 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-1822
Practice Address - Country:US
Practice Address - Phone:212-749-6626
Practice Address - Fax:212-749-6629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03587771Medicaid
NY03587771Medicaid