Provider Demographics
NPI:1801597125
Name:IBRAM PHARMACY INC
Entity type:Organization
Organization Name:IBRAM PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FEBY
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:MOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-667-6777
Mailing Address - Street 1:1762 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1932
Mailing Address - Country:US
Mailing Address - Phone:718-667-6777
Mailing Address - Fax:718-667-6778
Practice Address - Street 1:1762 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1932
Practice Address - Country:US
Practice Address - Phone:718-667-6777
Practice Address - Fax:718-667-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy