Provider Demographics
NPI:1336544469
Name:AUSTIN STREET PHARMACY INC.
Entity Type:Organization
Organization Name:AUSTIN STREET PHARMACY INC.
Other - Org Name:BJS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARKADI
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-793-1616
Mailing Address - Street 1:6860 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4245
Mailing Address - Country:US
Mailing Address - Phone:718-793-1616
Mailing Address - Fax:718-544-4993
Practice Address - Street 1:6860 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4245
Practice Address - Country:US
Practice Address - Phone:718-793-1616
Practice Address - Fax:718-544-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy