Provider Demographics
NPI:1881754141
Name:PRACHI CORPORATION
Entity type:Organization
Organization Name:PRACHI CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-424-9275
Mailing Address - Street 1:9101 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7919
Mailing Address - Country:US
Mailing Address - Phone:718-424-9275
Mailing Address - Fax:718-424-1289
Practice Address - Street 1:9101 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7919
Practice Address - Country:US
Practice Address - Phone:718-424-9275
Practice Address - Fax:718-424-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02501040Medicaid