Provider Demographics
NPI:1669708871
Name:RICHMOND PHARMACY INC
Entity type:Organization
Organization Name:RICHMOND PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIZWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-849-9800
Mailing Address - Street 1:12117 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2524
Mailing Address - Country:US
Mailing Address - Phone:718-849-9800
Mailing Address - Fax:718-849-9801
Practice Address - Street 1:12117 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2524
Practice Address - Country:US
Practice Address - Phone:718-849-9800
Practice Address - Fax:718-849-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6395600001Medicare NSC