Provider Demographics
NPI:1942638499
Name:905 HEMPSTEAD PHARMACY INC.
Entity Type:Organization
Organization Name:905 HEMPSTEAD PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MAN
Authorized Official - Prefix:
Authorized Official - First Name:QAISER
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-492-3201
Mailing Address - Street 1:905 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3633
Mailing Address - Country:US
Mailing Address - Phone:516-492-3201
Mailing Address - Fax:516-492-3204
Practice Address - Street 1:905 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3633
Practice Address - Country:US
Practice Address - Phone:516-492-3201
Practice Address - Fax:516-492-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-19
Last Update Date:2013-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17032346302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization