Provider Demographics
NPI:1972028819
Name:HOSAM INC
Entity Type:Organization
Organization Name:HOSAM INC
Other - Org Name:SAM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SUPERVISING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSAYYAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:646-620-6003
Mailing Address - Street 1:210 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1367
Mailing Address - Country:US
Mailing Address - Phone:718-513-6657
Mailing Address - Fax:
Practice Address - Street 1:210 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1367
Practice Address - Country:US
Practice Address - Phone:718-513-6657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy