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General NPI Number Information
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NPI Number | 1487083606
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Entity Type | Organization
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Legal Business Name | TRISTATE PHARMACY INC.
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 8924 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7739
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Country | US
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Telephone | 718-565-1900
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Fax | 718-565-6900
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Provider Business Mailing Address
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Address Line | 8924 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7739
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Country | US
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Telephone | 718-565-1900
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Fax | 718-565-6900
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAHID NAWAZ
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Credential |
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Telephone | 718-565-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 032279
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License Number State | NY
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