Provider Demographics
NPI:1912295775
Name:NEWKIRK PHARMACY INC
Entity Type:Organization
Organization Name:NEWKIRK PHARMACY INC
Other - Org Name:NEWKIRK PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:UMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-434-0931
Mailing Address - Street 1:1402 NEWKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6522
Mailing Address - Country:US
Mailing Address - Phone:718-434-0931
Mailing Address - Fax:718-434-0932
Practice Address - Street 1:1402 NEWKIRK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6522
Practice Address - Country:US
Practice Address - Phone:718-434-0931
Practice Address - Fax:718-434-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03360845Medicaid
NY03360845Medicaid