Provider Demographics
NPI:1750123121
Name:ICURE PHARMACY INC
Entity type:Organization
Organization Name:ICURE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBOJON
Authorized Official - Middle Name:BOTIROVICH
Authorized Official - Last Name:ISAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-516-4444
Mailing Address - Street 1:2110 NEWTOWN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2935
Mailing Address - Country:US
Mailing Address - Phone:718-516-4444
Mailing Address - Fax:718-540-7692
Practice Address - Street 1:2110 NEWTOWN AVE FL 1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2935
Practice Address - Country:US
Practice Address - Phone:718-516-4444
Practice Address - Fax:718-540-7692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy