Provider Demographics
NPI:1851154546
Name:BARAKAT PHARMACY INC
Entity Type:Organization
Organization Name:BARAKAT PHARMACY INC
Other - Org Name:ROOTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANAULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHIRDEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:718-223-3692
Mailing Address - Street 1:14 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5208
Mailing Address - Country:US
Mailing Address - Phone:718-223-3692
Mailing Address - Fax:
Practice Address - Street 1:410 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5504
Practice Address - Country:US
Practice Address - Phone:516-452-9046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy