Provider Demographics
NPI:1972902351
Name:101 FIRST CARE PHARMACY INC
Entity Type:Organization
Organization Name:101 FIRST CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-880-2346
Mailing Address - Street 1:18 E 183RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-1241
Mailing Address - Country:US
Mailing Address - Phone:718-880-2346
Mailing Address - Fax:718-880-2282
Practice Address - Street 1:18 E 183RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1241
Practice Address - Country:US
Practice Address - Phone:718-880-2346
Practice Address - Fax:718-880-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0329143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy