Healthcare Provider Details
I. General information
NPI: 1982925830
Provider Name (Legal Business Name): FAIR CARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2010
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1094 FLATBUSH AVE
BROOKLYN NY
11226-6101
US
IV. Provider business mailing address
1094 FLATBUSH AVE
BROOKLYN NY
11226-6101
US
V. Phone/Fax
- Phone: 347-305-3100
- Fax: 347-305-3099
- Phone: 347-305-3100
- Fax: 347-305-3099
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 030278 |
| License Number State | NY |
VIII. Authorized Official
Name:
WAHEED
AFZAL
Title or Position: PRESIDENT
Credential:
Phone: 646-201-8457