Healthcare Provider Details

I. General information

NPI: 1972668408
Provider Name (Legal Business Name): NKS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 UNIVERSITY PL
NEW YORK NY
10003-4511
US

IV. Provider business mailing address

50 UNIVERSITY PL
NEW YORK NY
10003-4511
US

V. Phone/Fax

Practice location:
  • Phone: 212-473-4166
  • Fax: 212-598-0585
Mailing address:
  • Phone: 212-473-4166
  • Fax: 212-598-0585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022821
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HITEN SHAH
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 212-473-4166