Provider Demographics
NPI:1922344795
Name:MYRTLE DRUG CARE CORP
Entity Type:Organization
Organization Name:MYRTLE DRUG CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:TEHFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-607-4014
Mailing Address - Street 1:1959 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4505
Mailing Address - Country:US
Mailing Address - Phone:718-824-3745
Mailing Address - Fax:718-824-3746
Practice Address - Street 1:355 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3216
Practice Address - Country:US
Practice Address - Phone:718-855-2292
Practice Address - Fax:718-855-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy