Healthcare Provider Details

I. General information

NPI: 1437306263
Provider Name (Legal Business Name): MONA PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 S BROADWAY
YONKERS NY
10705-2049
US

IV. Provider business mailing address

358 S BROADWAY
YONKERS NY
10705-2049
US

V. Phone/Fax

Practice location:
  • Phone: 914-969-7741
  • Fax: 914-969-4174
Mailing address:
  • Phone: 914-969-7741
  • Fax: 914-969-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number021061
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021061
License Number StateNY

VIII. Authorized Official

Name: MR. DHIRUBHAI N BHAGAT
Title or Position: PRESIDENT/ SP PHARMACIST
Credential:
Phone: 914-969-7741