1821033994 NPI number — FEIN'S ETHICAL PHARMACY CORP.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821033994 NPI number — FEIN'S ETHICAL PHARMACY CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FEIN'S ETHICAL PHARMACY CORP.
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:
Provider Other Organization Name Type Code:
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:
1821033994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2199 JACKSON PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH BELLMORE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11710-1104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-785-4817
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3586 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10031-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-862-3315
Provider Business Practice Location Address Fax Number:
212-281-7217
Provider Enumeration Date:
06/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MOHAMMAD
Authorized Official First Name:
OMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-862-3315

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  33078 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00260435 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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