Provider Demographics
NPI:1720634611
Name:MOTT HAVEN PRESCRIPTION INC
Entity Type:Organization
Organization Name:MOTT HAVEN PRESCRIPTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMCIST
Authorized Official - Prefix:
Authorized Official - First Name:RAMABHAI
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-292-9144
Mailing Address - Street 1:400 E 141ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2212
Mailing Address - Country:US
Mailing Address - Phone:718-292-9144
Mailing Address - Fax:718-292-9145
Practice Address - Street 1:400 E 141ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2212
Practice Address - Country:US
Practice Address - Phone:718-292-9144
Practice Address - Fax:718-292-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty