Healthcare Provider Details

I. General information

NPI: 1518510734
Provider Name (Legal Business Name): MADINA DRUGS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 FULTON AVE
BRONX NY
10456-3401
US

IV. Provider business mailing address

1225 FULTON AVE
BRONX NY
10456-3401
US

V. Phone/Fax

Practice location:
  • Phone: 929-476-0700
  • Fax:
Mailing address:
  • Phone: 929-476-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: J CIOLI
Title or Position: PHARMACIST IN CHARGE
Credential: PIC
Phone: 929-476-0700