Provider Demographics
NPI:1851563266
Name:NEVINS DRUGS INC
Entity Type:Organization
Organization Name:NEVINS DRUGS INC
Other - Org Name:NEVINS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:718-422-0100
Mailing Address - Street 1:739 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2969
Mailing Address - Country:US
Mailing Address - Phone:718-422-0100
Mailing Address - Fax:718-422-0118
Practice Address - Street 1:326 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1002
Practice Address - Country:US
Practice Address - Phone:718-422-0100
Practice Address - Fax:718-422-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0287403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2070199OtherPK
NY03036055Medicaid
2070199OtherPK