Provider Demographics
NPI:1922348218
Name:184TH ST PHARMACY CORP
Entity Type:Organization
Organization Name:184TH ST PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-787-5434
Mailing Address - Street 1:69 E 184TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-6501
Mailing Address - Country:US
Mailing Address - Phone:347-787-5434
Mailing Address - Fax:347-787-5435
Practice Address - Street 1:69 E 184TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6501
Practice Address - Country:US
Practice Address - Phone:347-787-5434
Practice Address - Fax:347-787-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0316633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy