Provider Demographics
NPI:1932141462
Name:EUREKA LABORATORIES INC
Entity Type:Organization
Organization Name:EUREKA LABORATORIES INC
Other - Org Name:CI CI PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SP OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-695-4232
Mailing Address - Street 1:9 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4716
Mailing Address - Country:US
Mailing Address - Phone:516-364-3799
Mailing Address - Fax:
Practice Address - Street 1:894 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3508
Practice Address - Country:US
Practice Address - Phone:212-695-4232
Practice Address - Fax:212-695-8658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0253533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3326700OtherNCPDP PROVIDER IDENTIFICATION NUMBER