Healthcare Provider Details

I. General information

NPI: 1982947420
Provider Name (Legal Business Name): BK PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 FLATBUSH AVE
BROOKLYN NY
11210-3946
US

IV. Provider business mailing address

1675 FLATBUSH AVE
BROOKLYN NY
11210-3946
US

V. Phone/Fax

Practice location:
  • Phone: 347-462-4662
  • Fax: 347-462-4664
Mailing address:
  • Phone: 347-462-4662
  • Fax: 347-642-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number39305
License Number StateNY

VIII. Authorized Official

Name: SUBRAMONY N IYER
Title or Position: PHARMACIST
Credential: PHARMACIST
Phone: 646-207-0574