1427045913 NPI number — RAM THAKUR ENTERPRISE INC.

Table of content: (NPI 1427045913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427045913 NPI number — RAM THAKUR ENTERPRISE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAM THAKUR ENTERPRISE 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:
VAN WYCK PRESCRIPTION CENTER
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:
1427045913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8820B VAN WYCK EXPY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND HILL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11418-2831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-658-0012
Provider Business Mailing Address Fax Number:
718-297-5600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
88-20B VAN WYCK EXPY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND HILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11418-2831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-658-0012
Provider Business Practice Location Address Fax Number:
718-297-5600
Provider Enumeration Date:
09/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RAKHIT
Authorized Official First Name:
ASHOK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-658-0012

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  022853 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 022853 , 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)

  • Identifier: 01611389 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3312509 . This is a "NABP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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