Provider Demographics
NPI:1245813476
Name:SERKET PHARMACY LLC
Entity type:Organization
Organization Name:SERKET PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANDASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-608-1675
Mailing Address - Street 1:8 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2702
Mailing Address - Country:US
Mailing Address - Phone:973-337-6031
Mailing Address - Fax:973-707-2692
Practice Address - Street 1:8 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2702
Practice Address - Country:US
Practice Address - Phone:973-337-6031
Practice Address - Fax:973-707-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy