=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093012635
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEWEL OF FLUSHING RX INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2011
-----------------------------------------------------
Last Update Date | 02/17/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7035 PARSONS BLVD
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11365-3049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-400-3173
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 70-35 PARSONS BLVD.
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11365-3049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-400-3173
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | NADEEM KAUSAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-400-3173
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------