Provider Demographics
NPI:1861486979
Name:MANNINGS 8TH AVE INC
Entity Type:Organization
Organization Name:MANNINGS 8TH AVE INC
Other - Org Name:MANNINGS 8TH AVE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ERNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-238-3850
Mailing Address - Street 1:6402 8TH AVE
Mailing Address - Street 2:G103
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4720
Mailing Address - Country:US
Mailing Address - Phone:718-238-3850
Mailing Address - Fax:718-238-3856
Practice Address - Street 1:6402 8TH AVE
Practice Address - Street 2:G103
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4720
Practice Address - Country:US
Practice Address - Phone:718-238-3850
Practice Address - Fax:718-238-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027289333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3345825OtherNCPDP
NY02685472Medicaid
NY3345825OtherNCPDP