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General NPI Number Information
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NPI Number | 1023114386
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Entity Type | Organization
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Legal Business Name | PRAYOSHA PHARMACY CORP.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 54 E 183RD ST
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City | BRONX
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State | NY
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Zip | 10453-1239
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Country | US
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Telephone | 718-220-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 54 E 183RD ST
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City | BRONX
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State | NY
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Zip | 10453-1239
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Country | US
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Telephone | 718-220-1900
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. PANKAJ R PATEL
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Credential | BS PHARM
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Telephone | 718-220-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 026460
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License Number State | NY
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