Healthcare Provider Details

I. General information

NPI: 1831003425
Provider Name (Legal Business Name): IMAN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 GRAMATAN AVE
MOUNT VERNON NY
10552-3008
US

IV. Provider business mailing address

505 GRAMATAN AVE
MOUNT VERNON NY
10552-3008
US

V. Phone/Fax

Practice location:
  • Phone: 914-665-5556
  • Fax: 914-665-5589
Mailing address:
  • Phone: 914-665-5556
  • Fax: 914-665-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MARWAN AMIN ABDULLAH
Title or Position: SP PHARMACIST
Credential: RPH, CNS
Phone: 914-665-5556