1912300849 NPI number — COMMUNITY AID PHARMACY INC.

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 1912300849 NPI number — COMMUNITY AID PHARMACY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY AID 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:
Provider Other Organization Name Type Code:
6
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:
1912300849
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
394 AVENUE P
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11223-1825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-339-8118
Provider Business Mailing Address Fax Number:
718-339-6385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
394 AVENUE P
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11223-1825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-339-8118
Provider Business Practice Location Address Fax Number:
718-339-6385
Provider Enumeration Date:
10/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ABBASOV
Authorized Official First Name:
SARDOR
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
718-339-8118

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 033183 , 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: 2149318 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04027758 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com