Provider Demographics
NPI:1861476384
Name:EVE 4 PHARMACY
Entity type:Organization
Organization Name:EVE 4 PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-743-8585
Mailing Address - Street 1:1634 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1026
Mailing Address - Country:US
Mailing Address - Phone:718-573-5555
Mailing Address - Fax:718-573-3240
Practice Address - Street 1:1634 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1026
Practice Address - Country:US
Practice Address - Phone:718-573-5555
Practice Address - Fax:718-573-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026094333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5023560001Medicare NSC