Provider Demographics
NPI:1972833747
Name:ABC DRUGS INC
Entity Type:Organization
Organization Name:ABC DRUGS INC
Other - Org Name:ABC DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-618-0510
Mailing Address - Street 1:1564 E 174TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-1203
Mailing Address - Country:US
Mailing Address - Phone:718-618-0510
Mailing Address - Fax:718-618-0509
Practice Address - Street 1:1564 E 174TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-1203
Practice Address - Country:US
Practice Address - Phone:718-618-0510
Practice Address - Fax:718-618-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029890333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123325OtherPK
NY3196903Medicaid