Healthcare Provider Details

I. General information

NPI: 1053449249
Provider Name (Legal Business Name): MNK PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 AMSTERDAM AVE
NEW YORK NY
10023
US

IV. Provider business mailing address

181 AMSTERDAM AVE
NEW YORK NY
10023
US

V. Phone/Fax

Practice location:
  • Phone: 212-877-6390
  • Fax: 212-877-6706
Mailing address:
  • Phone: 212-877-6390
  • Fax: 212-877-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021250
License Number StateNY

VIII. Authorized Official

Name: MR. MORRIS J KUBASHKY
Title or Position: PRESIDENT
Credential: RPH
Phone: 212-877-6390