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General NPI Number Information
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NPI Number | 1255838249
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Entity Type | Organization
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Legal Business Name | ALL GREEN PHARMACY LLC
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 04/06/2018
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Provider Practice Location Address
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Address Line | 16829 HILLSIDE AVE FL 2
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City | JAMAICA
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State | NY
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Zip | 11432-4440
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Country | US
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Telephone | 917-660-0413
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Fax |
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Provider Business Mailing Address
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Address Line | 16829 HILLSIDE AVE FL 2
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City | JAMAICA
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State | NY
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Zip | 11432-4440
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Country | US
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Telephone | 917-660-0413
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUFIZUL AHAD
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Credential |
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Telephone | 917-660-0413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332100000X
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Taxonomy Name | Department of Veterans Affairs (VA) Pharmacy
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License Number |
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License Number State | NY
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