Provider Demographics
NPI:1831186675
Name:M.B.AHMED DRUG CORP
Entity type:Organization
Organization Name:M.B.AHMED DRUG CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFIQ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PHARMACY
Authorized Official - Phone:718-424-1291
Mailing Address - Street 1:7419 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6529
Mailing Address - Country:US
Mailing Address - Phone:718-424-1291
Mailing Address - Fax:718-898-1860
Practice Address - Street 1:7419 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6529
Practice Address - Country:US
Practice Address - Phone:718-424-1291
Practice Address - Fax:718-898-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018751332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01119704Medicaid
NY01119704Medicaid