Healthcare Provider Details

I. General information

NPI: 1336868843
Provider Name (Legal Business Name): DREXEL DISTRIBUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PEACH ST
BUTLER GA
31006-5338
US

IV. Provider business mailing address

441 LEXINGTON AVE RM 1221
NEW YORK NY
10017-3931
US

V. Phone/Fax

Practice location:
  • Phone: 212-518-6900
  • Fax: 866-252-3902
Mailing address:
  • Phone: 212-518-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BEDIS ZORMATI
Title or Position: OWNER
Credential:
Phone: 212-518-6900