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General NPI Number Information
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NPI Number | 1235918129
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Entity Type | Organization
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Legal Business Name | SDPM UNITED PHARMACY INC.
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 917 WYCKOFF AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5353
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Country | US
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Telephone | 718-366-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 6 NURKO RD
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City | MILLSTONE TOWNSHIP
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State | NJ
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Zip | 08535-3808
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Country | US
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Telephone | 732-535-1094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DEEP DESAI
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Credential |
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Telephone | 732-535-1094
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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 |
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License Number State |
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