Provider Demographics
NPI:1669877510
Name:99 CENTS TOP GRADE INC.
Entity type:Organization
Organization Name:99 CENTS TOP GRADE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAFAIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-685-6042
Mailing Address - Street 1:1903 STORY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2705
Mailing Address - Country:US
Mailing Address - Phone:718-822-2905
Mailing Address - Fax:718-822-2924
Practice Address - Street 1:1903 STORY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2705
Practice Address - Country:US
Practice Address - Phone:718-822-2905
Practice Address - Fax:718-822-2944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0330273336S0011X, 333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7317820001Medicare NSC