Healthcare Provider Details
I. General information
NPI: 1053592527
Provider Name (Legal Business Name): NOOR PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2007
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2036 BEDFORD AVE
BROOKLYN NY
11226-1905
US
IV. Provider business mailing address
2036 BEDFORD AVE
BROOKLYN NY
11226-1905
US
V. Phone/Fax
- Phone: 718-282-8982
- Fax: 718-282-0428
- Phone: 718-282-8982
- Fax: 718-282-0428
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 028573 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUHAMMAD
ASHRAF
Title or Position: PIC
Credential:
Phone: 718-282-8982