Provider Demographics
NPI:1972668408
Name:NKS PHARMACY INC
Entity Type:Organization
Organization Name:NKS PHARMACY INC
Other - Org Name:WHITNEY CHEMIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HITEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-473-4166
Mailing Address - Street 1:50 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4511
Mailing Address - Country:US
Mailing Address - Phone:212-473-4166
Mailing Address - Fax:212-598-0585
Practice Address - Street 1:50 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4511
Practice Address - Country:US
Practice Address - Phone:212-473-4166
Practice Address - Fax:212-598-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NY0228213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1650357Medicaid
2057981OtherPK
NY1650357Medicaid