Healthcare Provider Details

I. General information

NPI: 1376900076
Provider Name (Legal Business Name): SERVAID PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 18TH AVE
BROOKLYN NY
11204-1928
US

IV. Provider business mailing address

5411 18TH AVE
BROOKLYN NY
11204-1928
US

V. Phone/Fax

Practice location:
  • Phone: 718-331-3600
  • Fax: 718-331-3099
Mailing address:
  • Phone: 718-331-3600
  • Fax: 718-331-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number034509
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD NABEEL
Title or Position: OWNER
Credential:
Phone: 718-331-3600