1215415856 NPI number — NTS PHARMACY INC.

Table of content: (NPI 1215415856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215415856 NPI number — NTS PHARMACY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NTS PHARMACY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KINGS CARE PHARMACY AND STORE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215415856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 E 149TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10451-5602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-684-1595
Provider Business Mailing Address Fax Number:
718-648-1598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
306 E 149TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451-5602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-684-1595
Provider Business Practice Location Address Fax Number:
718-648-1598
Provider Enumeration Date:
08/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MIR
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
TAHHUR
Authorized Official Title or Position:
OWENER/PHARMACY MANAGER
Authorized Official Telephone Number:
718-684-1595

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  033700 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)